4 year old with severe headache-anyone around to advise?

[fifitot]

DD has complained of a headache on and off all week and came home early from nursery because of it today.

Dozed on and off on sofa, refused food and drink and held her head, crying from time to time. Clearly in pain. Took to walk in centre who said glands in neck slightly raised, maybe dehydrated and/or kidney infection. However has no pain in abdomen and while urine very strong - think this is because she doesn't want food or drink.

She woke before crying with the head pain. So have given more Calpol but am a bit concerned - really don't think it can be kidneys. She has no rash and doesn't seem to have neck stiffness.

What should I do? She's sleeping now - if she wakes in pain should I go to A and E?

Yes, I would. It's not normal for four year olds to get headaches.

I would ring NHS direct to get advice, but yes if she wakes again, take her down to A&E, 4 yr olds don't usually get headaches. Good luck, hope she is ok.

I would take her to A and E if it doesn't improve. Are her extremeties particularly cold, does she have a temperature? I would also take her if she continues to refuse drinks - dehydration will definitely not improve her headache. Hope she feels better soon.

I would take her to A&E as well. Even if she feels better I would still take her to a GP in the next few days.

I'd also take her to A&, I hope she's OK

Would ring NHS Direct NOW, and be prepared to take her to A & E. When did she last drink? If she is dehydrated then being asleep is NOT a good thing.

Have had a child of mine with meningococcal meningitis so I DO know what I am talking about . Calpol can mask symptoms, and the rash is a red herring as it is not always there. Important symptoms are

can she bend her chin to her neck?
Will she close her eyes and avoid light?
Is she a drawn grey colour or flushed?
Are her hands and feet cold?
Does she have a high temperature at the moment?
Has she vomited?

If she doesnt have the above then the chances are it is just a nasty viral infection but you need to speak to NHS Direct.

It could be a virus, with her glands being up, but a week is a long time to have a headache. Advice for a persistent headache is to contact your GP straight away. Get an appointment for tommorrow if headache not gone in morning.

If she wakes enough to talk to you ask if pain anywhere else, could be tooth or ear related.

Keep her hydrated if she refuses drinks try lollies if you have any, anything to get some fluid into her.

If she seems in a lot of pain and Calpol not helping you can always call on-call doctor through GP surgery or NHS Direct on 0845 4647. You can also call NHS Direct for advice, I have done this before to give me piece of mind, they get a nurse to call you back.

Keep an eye on her if temperature above 38 degrees C with vomiting, rash that stays under a glass pressed onto skin, neck stiffness or senstivity to light contact take her to A&E straight away, better safe than sorry.

It's not abnormal at all for children to get headaches - but are you sure it's her head that's hurting and not her ears or something else? Sometimes young children aren't very good at describing or even understanding where a pain is coming from.

Thank you all. Rang NHS direct. They suggest wait a couple of hours to see if Calpol helps then ring back. Your advice has beeng reat. No temp at moment - trying to get fluids in and will decide what to do in a bit.

Will report back.

Well, what was the outcome? My dd has only ever complained of a headache once, she was around 5. I checked her over for obvious rashes etc and found none. Calpol didn't help so I took her to the hospital. She was tested for dengue fever (we were in Thailand) which fortunately came back negative. DD was admitted and given IV fluids and was as right as rain the next day. her headache it seems was down to dehydration.

Sorry so late coming back. Had to ring NHS back again as was violently sick twice and still not sleeping. Didn't really sleep all night and crying about her head hurting. They got OOH doc to phone who was less than helpful tbh. By this time (3) she was snoozing so left her in hope she would sleep it off.

However woke at 5.30 in pain again so have just returned from A and E. No obvious problem. Temp OK, they totally dismissed the urine infection issue, said probably a virus. Keep fluids up and alternate calpol and nurofen and see how she goes.

Currently half asleep on sofa watching a DVD. Am hoping she will sleep so I can get an hours kip in too.

Thanks for your help everyone.

The nurofen seems to have worked well, better than the Calpol and she perked up for a bit, even ate an ice lolly!

Glad to hear it Fifi, it is so worrying when they are ill and you just want to make it better for them. At least she is eating something, will she accept drinks now?

Had a few sips. She really picked up this morning but now has slipped back into being sleepy and crying cos of her head...........Not sure what to do next. Suppose just see how she is for rest of day and then go to GP if no improvement tomorrow.

It's all a bit baffling but the medics are saying virus so I guess that's what it is.

Poor thing - she sounds like she is in constant pain. She can't go on like this, surely?

This seems odd. I would be seriously considering asking for an MRI. It is just too long, imo, for a 4 year old to be complaining like this.

I would ask for MRI as well.

This is not normal.

Headaches and vomiting (especially in the morning) are one of the signs of brain tumour.
I don't mean to scare you, but I think you should go see GP or perhaps back to A&E and ask for a scan. Not sure what's the best way of getting one as I don't live in the UK-hopefully someone else will know.

Also there were cases of children having meningitis without fever and feeling ill for days- so it seems to not always be a scenario of very rapid degradation from feeling well iyswim.

Stroke?

All these scenarios are very unlikely, of course, but better safe than sorry and all that.

Try not to worry yourself Fifi, often with a virus it gets worse in the afternoon/evening. Sleep and hydration are the best things for a virus, her body will fight it off all by itself. Just keep an eye and if you feel it is getting much worse i.e. very high temp, vomiting increasing, high pitch whining/crying then call doctor again. Often viruses can go on for several days, but as the others have said if it persists then take her back to docs for further investigation.

She is communicating normally, just a bit tired and has just ate some cereal. Don't scare me with tumour stories! If it hasn't gone in the morning then will go back.

There is no more vomiting and no temp. Will bear in mind what you say and think about what to do next. Thanks.

I suffer from Migraines and she is presenting exactly how I do when I have one. Doc said she was a bit young to have a migraine but not so sure.

I think this particular headache has now lasted 24 hours, the ones earlier in the week I think came and went. It's a puzzle but am keeping an eye on her.

Sorry, Fifitot, didn't want to scare you.

It's just that if it goes on for a few days more, I would be insisting on further tests, that's all.