Management of headaches in children.

Headaches are a common cause of disability in childhood. Although the symptom of headache raises concerns about serious neurologic disease, the cause is most commonly vascular or due to muscle contraction. The differentiation between muscle-contraction and vascular headaches is clinical, and laboratory studies rarely are required. Treatment of muscle-contraction headaches is symptomatic. Migraine headaches sometimes require periods of prophylactic therapy. The chronic nature of headaches mandates a comprehensive approach to management of the child and family. This approach is best carried out in the primary care setting.