What Causes Constant Headaches After An Adenotonsillectomy?

Posted on Tue, 24 Apr 2018

Question: My daughter (5.6 years) had an adenotonsillectomy done in January this year...Since then she is complaining of headaches, these were off and on episodes which she had if she had disturbed sleep. A dose of ibugesic plus would relieve her..but since last 20 days she has been experiencing continuous episodes of headaches..She also had flu and fever so the pediatrician associated it with it....But when the flu gone she is still experiencing these headaches..She says the pain originate from the back of her neck and travel through half of the head..As suggested by Pediatrician again , we eye check up done and those reports were normal.

In the last followup with Pediatrician two days ago, he advised to get MRI Brain Scan+EEG tests to get the root cause.

Below are few questions I need help clarified:

1. Is the condition so grave that MRI Brain Scan+EEG is recommended.
2. Could it be migrane? Do kids of this age have migrane?
3. Is there any other way or option left to rule of the reason for continous headaches?
4. Who do we consult to get an expert advise. Neurologist? Another pediatrician? ENT pediatrician?..

Answered by Dr. Ishu Bishnoi (30 hours later)

Brief Answer:
Answers of your queries

Detailed Answer:
Hi XXXXXXX thanks for asking from HCM.

I can understand your concern. Your daughter is having hemicranial headache. Such kind of headache in children could be due to

- Ipsilateral eye disease (already ruled out)
- Classical Migraine - Small children can also develop migraine. It usually presents with headache episodes along with vomiting, photophobia, aggravated by lack of sleep/bright light/mental stress/change in season.
- Ipsilateral ear infection
- Ipsilateral air sinus infection e.g. frontal/maxillary/ethmoidal/sphenoidal sinusitis. It usually occurs after flu/common cold. It presents with post nasal discharge, heaviness in head, more pain on bending forward.
- Mass lesion in brain e.g. brain tumor/vascular malformation.

Now coming to your queries.

1 - MRI brain can help a lot in differentiating various causes. EEG should not be done initially. It can be done after MRI brain, if doubt still persists.

2 - It might be migraine. Kids at this age can also develop migraine.

3 - Clinical examination, history can also help in confirming illness. Fundus examination (eyes) can rule out raised intra-cranial pressure.

4 - You should consult neurologist. He/she will examine her and take detailed history.

Hope it will help you. If you need any help, do let me know. Please message me her reports.
Thanks. Take care.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D