Headaches in Children
by Leonardo Garcia-Mendez, M.D.

Headaches in Children, by Pediatric Neurologist Leonardo Garcia-Mendez, claims in its subtitle to be a "Practical Informative Guide for Parents, Teachers and Paramedical Personnel." Fortunately, this brief book comes close to achieving this goal and also fills a longtime gap in headache literature. Pediatric headache has been recognized as a common problem for some time, but there has been little consensus as to its significance or treatment.

In the meantime, parents and children wondered and worried about such dire possibilities as brain tumors or abscesses. Dr. Garcia-Mendez, with considerable clinical experience, recognized his patients' suffering and their need for suitable treatment and mediation. He also found that parents and patients needed to discuss these fears with a doctor, and in most cases to be reassured by an examination, findings and conclusions. Just talking to these young sufferers brought about incredible improvement.

The children's examinations were standard neurological checkups, usually including laboratory tests, EEG's, CT scans and occasionally MRIs. Some patients had tension-type headaches and some had migraines, but they were basically healthy and without psychological problems. Over the years, Dr. Garcia-Mendez has seen thousands of such youngsters and adolescents.

Dr. Garcia-Mendez has developed one unique form of treatment and tested it on numerous young patients. Two or three times daily the children are given small amounts of Xanthinea and caffeine or theophylline (a substance similar to caffeine): in other words coffee, tea, or colas. Caffeine is frequently used in pain medication, but has pain-killing properties of its own plus vasoconstrictive action that could stop head pain. He noted success with this regimen with only 2 or 3 mg of caffeine daily, far less than the 120 mg of an average cup of coffee - amounts unlikely harmful to a child. The simplicity of this idea makes it seem incredible.

The above material is largely presented in the Prologue and Introduction. What follows is a detailed consideration of how headaches work, their causes, and their 'Clinical Evolution." Chapters on tension-type and migraine headache cover more familiar ground, with suggestions for diet, frequent meals or snacks, and trial of the doctor's prescription of small amounts of caffeine. His tension-type headache patients showed an amazing 90% improvement and migraine patients also improved tremendously (no figures given here). The following chapters discuss typical examinations of child headache patients in detail as well as various tests and their purposes.

The final chapter ties up previous analysis with overall treatment advice, especially the need for a detailed history and neurological exam for each child. Special tests are recommended on an individual basis. Medication is described, but emphasis is placed on diet, snacks, and especially the need for these patients to eat a simple breakfast (many do not!). Dr. Garcia-Mendez recommends these children limit their activities while still learning to plan schedules that include their favorite pastimes.

Headaches in Children at first seemed overly technical. Yet perhaps more facts and figures on his own prescription of caffeine or a controlled test of its use (admittedly difficult to do) would be instructive. This reader, however, was soon captivated by Dr. Garcia-Mendez's main concern throughout: improvement, release from pain, and the assurance of a normal life for his patients.

Book Reviews & Other Books by Dr. Garcia