Aman’s Story

Site created on October 30, 2018


Dr. Aman P. S. Sohal - U.K Board certified pediatric neuro consultant in Dubai


Dr Aman PS Sohal is a U.K Board certified Pediatric Neuro Consultant with over 11 years of experience in Pediatrics which includes more than six years of experience as a Consultant in Pediatric Neurology.


Neuropedia Children’s Neuroscience Center is the first highly specialist pediatric neuroscience center in UAE, offering state-of-the-art expert care to children and young people across the UAE and GCC countries.

Neuropedia, the neuroscience center in Dubai provides comprehensive care for infants, children and young people with a wide spectrum of acute and chronic neurological, developmental, behavioral and psychological disorders.

The Pediatric Neuroscience specialist care is provided by a board-certified team of highly qualified, motivated and passionate health professionals keeping the child and family at the center of decision making process. At Neuropedia Dubai, we bring together pediatric neurologists, child psychiatrists and allied health professionals trained in the UK, Europe and USA. We believe in a multi-disciplinary approach and work together to cater to the needs unique to each child and family. We see children from ages 0-16 years and in some special circumstances up to 18 years of age. Children’s neuroscience center never fails to provide children and families with a comprehensive approach from initial diagnosis and treatment to rehabilitation and long-term follow-up care under one roof.

Newest Update

Journal entry by Neurokids doc

What parents need to know about different types of headaches in children…

An informative article by Dr. Aman PS Sohal


Headaches in children are one of the most common types of pain. The

prevalence of a headache ranges from 20% in children younger than five

years, 37 to 51% in seven-year-old children, gradually increasing to 57 -82%

by 15 years of age. A headache may result in significant disability, including

missed school days and extracurricular activities, suboptimal participation in

regular activities, and loss of productivity.


What are the different causes of Headaches in Children?


There are various types of childhood headaches but the common ones which

are encountered in Pediatric Neurology Clinic are discussed below.


1. MIGRAINE:


Migraine headache is defined as multiple attacks, at least 4-5, of intense

unilateral (usually one-sided) headaches with a throbbing sensation.

These headaches, especially in younger patients, can be accompanied by

nausea, vomiting, insensitivity to bright lights and sound lasting from 1-72

hours.


Children may have associated “Aura” which includes visual symptoms e.g:

seeing zig-zag lines and patterns, rainbow colours, blurred vision, smell, or

speech changes etc. Younger patients may also have periodic variants such

as abdominal migraines (associated with tummy pains), cyclical vomiting,

vertigo and dizziness.


Why does my child have Migraine?


Migraines seem to be due to a combination of genetic susceptibility (60%-

70%) and environmental factors. Therefore a family history of a migraine is

 

important for your doctor. There are also a couple of theories: the vasogenic

theory and the neurovascular theory, with later being more “scientific”.


How can I treat Migraine?


It is very important that the parents seek the advice of a doctor who

experienced in managing headache in children who will carry out a proper

history taking and simple bedside tests, which include fundoscopy (checking

“back of the eyes”) before making a diagnosis of Migraine. Neuroimaging e.g.

CT or MRI Brain is not needed once a convincing history and normal

neurological examination are established.


The author recommends the 2-prong approach to manage a migraine which

includes lifestyle modification and medical management.

Recognition of certain trigger factors causing migraine and learning to avoid

these triggers e.g caffeine-containing food products is the key.

Apart from this, adequate hydration, a regular sleep schedule, stress

management, and regular exercise are very helpful remedies.

These lifestyle changes are under-rated but are extremely effective and

enough to stop the attacks at times. A headache diary is extremely important

to establish the frequency, intensity etc. of a migraine before embarking on

starting medications.


Once an attack starts, sooner the abortive medication is given, the more

effective it will be to decrease the intensity of the attack.

If a child is having to use abortive medications regularly or has two or more

Migraine attack per week, then prophylactic medication is recommended.

These medications are taken on a daily basis for a few months, following

which your doctor will slowly taper them off before completely stopping them.


2. TENSION HEADACHE


Tension headache can occur up to 15% of young people and are usually less

painful than migraines. These headaches have a “band-like” quality, are

shorter in duration, bilateral, usually in the temples. They are typically worse in

 

the afternoon and evening with a muscular component, especially in the neck

and upper back.


The treatment of tension headaches is usually conservative with an aim to

decrease the stress-related event giving rise to headaches. The author usually

treats these with simple over the counter medications like paracetamol and

Ibuprofen with an advice not to overuse these medications to avoid

“medication overuse headaches”.


3. CLUSTER HEADACHE


Cluster headaches are rare in children but are quite distinctive. Children with

cluster headaches have multiple severe headaches over a period of several

weeks or months, followed by relatively long headache-free intervals.

The pain is usually unilateral, frontal and watering of the eye on the side of

headache are common. The pain is so severe that children cannot lie still,

bang their head with their fists, or rock back and forth. The attack must be

recognised early and treated.


4. CHRONIC DAILY HEADACHE


The term chronic daily headache does not define any particular type of

headache, but children usually complain of “dull ache” to high-intensity pain on

a daily basis. The cause may include overuse of analgesic medications,

depression, poorly treated migraines or tension headaches. More often than

not there are underlying psychological issues which may aggravate the

headaches.


In Author’s opinion, these are by far the most difficult group to manage,

therefore a multi-disciplinary approach is important in the management.

It is important to discontinue overuse of analgesics and stick to various

lifestyle modifications mentioned above. Various medications have been used

with beneficial effects.


It is important to involve a Child Psychologist to unpick any underlying

psychological factor causing aggravation.

 

They would suggest various Relaxation techniques which increase both

physical and psychological well-being to counteract pain states. They may

also carry out Cognitive Behaviour Therapy helping the sense of control over

pain, reducing the fear of pain, enhancing function, increasing feelings of

hopefulness and resourcefulness, and improving mood.


In Summary, headaches in children are under-diagnosed entities which need

careful monitoring and treatment to avoid long-term morbidity and improving

the child’s psycho-social well being. A multidisciplinary approach including

Pediatric Neurologist, Paediatrician and Child Psychologist should be

undertaken wherever possible.

 

Dr. Aman PS Sohal is a U.K trained Consultant Pediatric Neurologist with dual

training in Pediatric Neurology and Neuro-physiology. He moved to the U.A.E

in 2015 after working at Birmingham Children’s Hospital UK for a few years.

He is Co-founder and Clinical Director of Neuropedia Children’s Neuroscience

Center, Dubai where he is currently based.

 

Courtesy: Asian Lite Media
Patients and caregivers love hearing from you; add a comment to show your support.

Comments Hide comments

Can you help power Aman's site?

A $30 donation powers a site like Aman's for one month. Help keep CaringBridge online for them and for you.

Show Your Support

See the Ways to Help page to get even more involved.

Personal Fundraiser
Support Links
Helpful Tasks
SVG_Icons_Back_To_Top
Top