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Upset, crying, head pain, medication for sinus, MRI of brain, EEG, gelastic epilepsy. Causes ?

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my 4 year old grandson has this problem when he gets upset his head hurts bad.he starts pulling at his head trying to get it to stop
this is not normal i dont daughter took him to a specialist and he said it was sinus.he has been taking medication for it but he really suffers when he gets upset because you can see how much pain he is in with the head hurting
Posted Fri, 4 May 2012 in Child Health
Answered by Dr. Susanta Padhy 46 minutes later

Thanks for the query.

The information you have provided seems inadequate.

However, with the available information, common possibilities are:

1. When he has severe pain in the head that is intolerable to him.

2. Few children throws tamper tantrum (fairly common between 3 to 5 years and is normal), a temperamental difficulty. But, it is to be consulted when tantrum is severe or lasting for a long period.

3. Associated stress to child, within family, separated parents, or any other psychological issues with which child is struggling with.

4. Any other associated medical condition.

But, as you said that he pulls his hair when he is upset, this may be because of stress as mentioned above or may be Trichotillomania.

Continue with the medications for sinus problem as suggested by your doctor. Apart from continuing these medications, you may discuss the above-mentioned possibilities with him and ask him whether a child psychologist need to be consulted .

Hope I have answered your query.

I am available to answer your follow up questions further.

Above answer was peer-reviewed by
Follow-up: Upset, crying, head pain, medication for sinus, MRI of brain, EEG, gelastic epilepsy. Causes ? 7 hours later
hello he doesnt throw tantrems.if he hurts himself or just starts crying he automatically gets these bad pains in his see him start to scream as such because the pain in his head is hurting have to try and settle him down quick to ease this pain
Answered by Dr. Susanta Padhy 21 hours later
Hello dear

I sincerely apologize for the delay in replying to you.

It seems the sequence of events (hurting, getting upset, pain and pulling hairs) is important in this case.

If plethora of events starts with "getting upset for some reason", than, may be psychological component could be a possibility.

But, if the pain starts after hurting or crying, without any apparent reason, than, may be some vascular causes or neurological causes for severe headache could be looked into. Is the child responding to treatment prescribed for sinus problem by the local doctor ?

And I could not get any reply from you regarding for presence of any psychosocial issues. It is unlikely to be related to trichotillomania.

The diagnosis in children needs careful observation and careful history taking by a competent specialist followed by any investigations, if necessary. Moreover the dictum is first to rule out any organic cause even if you are suspecting psychological reason.

Have you done any investigations or have your local doctor have suggested any investigations ?

Hope this answer is useful to you.

Wish your grandson a speedy relief of pain.


Above answer was peer-reviewed by
Follow-up: Upset, crying, head pain, medication for sinus, MRI of brain, EEG, gelastic epilepsy. Causes ? 2 hours later
Hello i definately feel it is a vascular thing too because it happens when he only starts to cry and we have noticed it a couple of times when he even starts to laugh.It is like their is pressure and this is what makes his hurt hurt.How do you determine if it is a vascular thing that sets it off?
Answered by Dr. Susanta Padhy 11 hours later
Thanks for one additional information that you say that it has occurred few times when he started to laugh which make me to think a possibility of seizure disorder (gelastic epilepsy [rare}or may be a part of behavioral component or XXXXXXX of complex partial seizure). Headache may be a part of XXXXXXX

And as because, sometimes emotional events like laughing, crying or any stressful thing can precipitate seizure and the age of the child is 4 years old, seizure disorder can be a posibility, which may be of vascular or non-vascular origin.

In that case, he should be consulted with a specialist (pediatric neurologist or neurologist or peditrician in that order of preference) and the doctor might ask you to do EEG, MRI Brain, if he thinks seizure disorder a possibility. MRI Brain can identify any vascular lesion.

Moreover, usually, seizure episodes last for few seconds to few minutes, client might feel sleepy after the episode is over, course is episodic nature. Professionally speaking, sometimes it is really difficult to say weather it is seizure or not, though in very small percentage of cases.

I am available to continue discussing further,

Wish your grandson a quick recovery

Thank you
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