Medical history for headaches

A medical history is the most important tool a doctor has to evaluate your headaches. If your child or teen has headaches, the doctor will want to talk to you and your child. The doctor may also want to talk with your teen in private to discuss any emotional issues.

Questions during the medical history often focus on your description of your headaches, the pattern of your headaches, and whether people in your family have a history of headache problems.

Headache description

• Where does your head usually hurt during a headache-all over, on one side, or just in one spot? Do you have different kinds of headaches?
• How often do you get a headache? How long do the headaches usually last? What time of day do the headaches start?
• Describe the headache pain. Is it stabbing, dull, pulsating, aching, or sharp? Is the pain constant, or does it come and go? How severe is the pain?
• Do any warning signs occur right before a headache begins? These might include visual changes (seeing jagged or zigzag lines, stars, flashing lights or colors, illusions with distorted size or shape), numbness in your arms or legs, or a sudden feeling of energy, fatigue, hunger, restlessness, or quick temper.
• Do any other symptoms occur with the headaches? Other symptoms may include fever or chills, lethargy, confusion, nausea and vomiting, stiff neck, weakness, numbness, vision problems, problems with walking, or loss of bladder control.
• Have you noticed anything that seems to trigger the headache, such as drinking alcohol, eating a particular food, or the start of your menstrual period? Do the headaches occur after physical exertion, such as exercise, sex, coughing, or bending?
• What seems to make the headaches worse? What helps the headaches go away?

Headache pattern and family history

• Have you had a recent head injury? Have you had a recent illness, such as flu, sore throat, or cold? Do you have any allergies?
• Have you had headaches in the past? Are your headaches always the same, or do you have different kinds of headaches?
• Do your headaches follow a usual pattern (beginning suddenly, occurring at certain times of the day or month)? Has the pattern of your headaches changed? Are you having headaches more often? Has the pain recently gotten worse or better?
• Are you taking any prescription or nonprescription medications for your headaches? Which ones are you taking, and how often do you take them? Do they work? Are you taking medications for any other medical condition?
• Have your headaches affected your performance at work or school? (School report cards may be a clue for the parents of children with headaches.)
• Have you had any changes in your sleep pattern? Are you experiencing physical or emotional stress?
• Is there a history of headaches in your family? Family history (genetics) is a very strong risk factor for migraine headaches.

If a child or teen has headaches, the doctor may also ask questions about the mother's pregnancy, labor, and delivery; the child's growth and development, behavior, and school performance; family conflicts; and any previous injuries or problems with the head. The doctor will also ask whether the child looks sick when he or she has a headache.