Is Your Teen Struggling With Headaches? Signs the Issue May Be Neurological

If your teen complains of headaches, it’s important to ask a number of follow-up questions, as there are many different types of headaches, each of which is treated differently.

At Advanced Neurology Specialists, LLC, board-certified neurologist Dr. Cory Lamar diagnoses and treats all forms of headaches at his office in Naples, Florida.

Some headaches are the result of neurological conditions, meaning they result from damage to, or improper functioning of, the nervous system. Here, our expert describes signs that indicate your teen may have a neurological headache.

Types of headaches

Headache as a whole can be broken down into 2 major categories: primary and secondary.

A primary headache is its own problem; it doesn’t occur due to any underlying condition, like high blood pressure or a tumor. It needs to be treated directly.

A secondary headache is caused by an underlying condition. Treating the causative condition will resolve the headache.

Primary headaches can be further broken down into 3 categories:

1. Tension-type headaches (TTHs): due to tension or muscle spasms in the neck; feels like a vise around the head
2. Migraine: a neurological disorder that produces one-sided, throbbing headaches in addition to neurological symptoms
3. Cluster headaches: excruciating headaches up to 8 times a day lasting for weeks or months (clusters)

Of the 3, migraine is the type most associated with neurological dysfunction.

More about migraine

Migraine isn’t just a bad headache. In fact, some people get migraine attacks that aren’t associated with pain – they just get the neurological symptoms.

Migraine involves physical changes in the way the brain processes sensory information and regulates pain.

Migraine progresses through 4 phases, each with its own set of symptoms.

1. Prodrome

This promontory phase starts 2 to 3 days before the pain phase hits. It’s characterized by neurological symptoms such as sensitivity to light, sound, smell, and touch, as well as excessive yawning, fatigue, and difficulty concentrating.

2. Aura

People either have migraine with aura or migraine without aura. If present, the aura starts about 10 minutes to an hour before the pain hits.

Neurological symptoms that characterize this phase include flashing lights or zig-zag lines across the visual field, difficulty with speech, confusion, and tingling in the limbs.

3. Pain

This is the phase most people think of when they hear the term “migraine.” The pain is usually on one side of the head, throbbing, and can last anywhere from 4 to 72 hours.

Neurological symptoms that accompany this phase may include sensitivity to light, sound, smell, and touch; nausea; and vomiting.

4. Postdrome

Once the pain starts to fade, you’re still not done with the migraine attack. This last phase is like a post-adrenaline crash. You feel tired, confused (brain fog), and generally unwell. Symptoms can last 1-2 days.

Having your teen keep a diary of their headaches, including what, if any, symptoms they have other than pain, can help determine if there’s a neurological cause and inform treatment.

Treating migraine

While staying in a dark room, putting a cold pack on the back of your head, or going to sleep may help resolve a minor migraine attack, medication is still the best way to prevent attacks from occurring and abort them when they show up.

Botulinum toxin type A (Botox®) is FDA-approved to be used as a migraine preventive, and it may help reduce the severity and frequency of migraine attacks if they’re chronic (occur more than 15 days a month).

A newer class of medications that targets a protein called calcitonin gene-related peptide (CGRP), a molecule that plays a role in how you experience pain, can be used both to prevent and abort attacks. The first CGRP inhibitor – erenumab-aooe (Aimovig) – was approved by the FDA on May 17, 2018.

CGRP medications are now considered a first-line treatment for migraine.

Several medications, such as some antidepressants, target the neurotransmitter serotonin in the brain, whose levels have been shown to be lower in people living with migraine. Serotonin helps modulate both mood and pain.

And a class of drugs called the triptans (e.g., Sumatriptan and Zolmitriptan) has been used since the 1990s to help abort migraine attacks once they’ve started. These medications also work on serotonin pathways.

If your teen is struggling with headaches that come with symptoms other than pain, it’s a good chance they may have migraine, and Advanced Neurology Specialists, LLC, can help. Call our office today at 239-667-5878 to set up a consultation with Dr. Lamar, or book online.