Painful, chronic, or recurrent headaches can be disabling and affect your child in many ways -- from their academic and athletic performance to their social and family life. Understanding the type of headache, and identifying the cause when possible, can help your child manage their headaches and, ideally, reduce headache severity and frequency. As pediatric headache specialists, we treat the most straightforward, as well as the most complex, headaches that affect children. We develop a comprehensive care plan to improve your child’s headaches and improve their quality of life.

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Treating Children with Chronic Headaches

When your child has recurring headaches, it’s natural to worry about worst-case scenarios. Whether we are the first headache specialists your child visits, or you are coming for a second opinion, our pediatric headache specialists address your concerns and work with you and your child to help them feel better.

Migraines or Tension Headaches
In many cases, children experience primary headaches such as a migraine or tension headaches. These can be managed with an effective treatment plan designed to minimize their frequency and the severity of their symptoms.

Secondary Headaches that Result from Injury or Illness
If your child experiences secondary headaches (headaches that are the result of an injury or other illness), we coordinate the necessary evaluations with the appropriate pediatric specialists. We work together to provide headache treatment so your child gets relief.

Duke Children's Hospital and Health Center

Learn about the child- and family-centered care offered at Duke Children's Hospital and Health Center so you can prepare for your child's appointments.

Chronic Headache Treatments

Your child’s comprehensive evaluation will include a headache and medical history, as well as a thorough neurological exam. A migraine disability scale will be completed by the caregiver and reviewed during the visit. This questionnaire evaluates how disabling headaches are for your child. Additional diagnostic testing may be ordered if needed.

Behavioral Therapies

Behavioral therapies, such as cognitive behavioral therapy (CBT), provide additional support to help decrease disability and improve functionality in a child with headaches. Children who experience depression or anxiety are referred to a local psychologist and/or psychiatrist.

Headache Medication

Children with frequent headaches may be prescribed daily headache medications to decrease the severity and frequency of their headaches. Episodic medications are also recommended to treat headaches when they happen, to relieve pain and other symptoms related to a headache. 

Botulinum Toxin (Botox) Injection

Botulinum Toxin A (Botox) treatments may be recommended for children age 12 and older who have chronic migraine headaches that have not responded to other treatments. Although the reasons why Botox works are not well understood, there is strong evidence that it can effectively reduce the number and severity of migraine headaches.

Complementary and Alternative Therapies

Vitamins and supplements may play a role in reducing the severity and frequency of headaches. Biofeedback, acupuncture, yoga, physical therapy, and mindfulness training may also be recommended. We provide referrals to appropriate community resources if these therapies are part of your child’s treatment plan.

Migraine Action Plan

We help create a Migraine Action Plan to ensure that your child receives prompt treatment at school at the earliest signs of a migraine. The plan helps office staff and school nurses determine quickly if your child needs prescribed medicine, so a headache doesn’t progress and cause your child unnecessary pain or significant missed class time. 

Why Choose Duke

Extensive Experience
Our pediatric neurologists, headache pediatric nurse practitioner/pediatric mental health specialist, and social worker are able to help most children who follow a care plan to reduce headache frequency and severity. We place a high value on listening carefully to you and your child and making all of you feel comfortable and at ease. We’ll apply our extensive experience and resources to help your family and child get back to a normal life. 

Transition to Adult Headache Clinic
We see children up to age 21 and then transition them to our adult headache clinic.

Benefit from our Ongoing Research
Your child may benefit from access to our active research program to improve treatment for children and adolescents with chronic headache.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Patient Resources

This page was medically reviewed on 03/21/2022 by