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School of Medicine
Johns Hopkins Bayview News - Out of the Darkness
Out of the Darkness
Date: October 7, 2013
The Pediatric Headache Center returns teen to life’s everyday joys
For 15 months, intense head pain enveloped Katie Lankford’s life.
When the bright, athletic 15-year-old began experiencing headaches in 2011 after a bout with mononucleosis, she stopped swimming competitively. She stopped playing music. She stopped attending classes at Towson High School. She even stopped socializing with her friends. Light and noise bothered her. She couldn’t eat. She couldn’t sleep. Headaches—and the severe pain that accompanied them—consumed her.
“The pain is something you can’t really describe,” says Lankford, a Lutherville, Maryland, resident. Along with her parents, Steve and Robin, and older sister Lauren, she spent months researching and visiting specialists, trying to find a treatment that would alleviate her head pain. At times, acupuncture and certain medication combinations would work. But the relief never lasted.
“Within a couple of weeks, the treatments would stop working,” she says.
And the pain always returned.
By December 2012, the Lankfords were desperate for a new solution. That’s when they turned to neurologist Christopher Oakley, M.D., medical director of The Pediatric Headache Center. Each year, The Pediatric Headache Center treats more than 800 patients ranging from ages 2 to 18 who suffer from severe headaches.
Many patients, including Lankford, come to the center after months or even years of failed headache therapies, Dr. Oakley says. “A lot of people don’t give it the due it deserves,” he adds. “They say, ‘It’s just a headache.’” But when it affects a patient’s everyday life, it’s much more serious. Dr. Oakley, who also suffered from migraines as a young adult, remembers meeting Lankford for the first time. “She was miserable,” he says.
When he examined the back of Lankford’s head, she burst into tears. Even the light touch of Dr. Oakley’s hand caused her body to shake with pain, she says.
Dr. Oakley diagnosed Lankford with occipital neuralgia, a neurological condition where the occipital nerves that run from the top of the spinal cord through the scalp are inflamed or injured. To treat it, he injected numbing medication and steroids into her head. For the first time in more than a year, Lankford finally felt relief.
“After the injection, she sat up and wiped the tears from her face,” Robin Lankford says. “It was a very humbling experience.”
But medications are only part of the multipronged approach at The Pediatric Headache Center. Patients also are assessed for sleep patterns, hydration levels, diet, exercise routines and stress levels—all factors that can contribute to headaches. Many patients have found relief simply by cutting out caffeine or getting an extra few hours of sleep,” explains Dr. Oakley.
“Lifestyle is important,” he says. “It’s like building a home; you start with the foundation.”
Alternative and complementary therapies to alleviate pain, such as biofeedback, a technique that trains patients to improve their health by using signals from their bodies, and acupuncture, also may be used.
In addition, The Pediatric Headache Center may refer, when appropriate, to social workers and psychologists to help patients cope with stress. Vitamins and supplements can be part of the treatment plan, as well. Every treatment plan is different because every patient is different. Still, the majority of patients who follow center recommendations find relief.
“With time, I really believe we can make the vast majority of these kids better,” says Dr. Oakley.
In the Clear
A combination of several medications, vitamins and therapies, including acupuncture, melatonin, Vitamin B2 and magnesium, have Lankford back on her feet again.
Says Dr. Oakley, “She walks in now and she’s got a smile on her face. She’s happy, and she’s feeling like she can actually function.”
While she still gets the occasional migraine headache, Lankford is sleeping better and eating better. She attended her junior prom in May and is going out with friends again. This fall, the senior plans to return full time to Towson High School, where she will play trombone in the jazz band.
“I’m so excited for this year,” she says.
To make an appointment at The Pediatric Headache Center, call 410-955-4259.
Conditions treated include:
Migraine headaches: Headaches that cause severe throbbing or a pulsing sensation in the head and are usually accompanied by vomiting, nausea, and sensitivity to light and sound. They can last for hours to days and are the most common reason pediatric patients visit The Pediatric Headache Center, Dr. Oakley says.
Chronic daily headaches: Headaches that occur 15 days or more a month for at least three months for chronic migraine or for at least six months for chronic tension, Dr. Oakley says. Patients can suffer from chronic migraines or chronic tension headaches, which cause mild to moderate pain on both sides of the head; or hemicrania continua, which causes pain, moderate to severe, on only one side of the head.
- Post-traumatic headache (PTH): Headaches that result from a head or neck injury. They can strike at the time of the injury and continue for up to two months post-injury. They also can resemble migraine and tension headaches.
When to See a Specialist
According to Dr. Oakley, between 30 and 50 percent of children in elementary school experience recurrent headaches. That percentage jumps to 50 to 60 percent for students in middle school. And for teens, it jumps to between 70 and 80 percent.
“Headaches are a common problem in kids,” Dr. Oakley explains. “Hardly ever is there anything seriously wrong, but these headaches can have a serious impact on the quality of a child’s life. If a child’s headache is ongoing, not improving or worsening, and interfering with his or her daily life, it’s time to see a specialist.”
“I tell kids if they can’t have a normal life, something needs to be done,” he says.
The Pediatric Headache Center is home to some of the nation’s leading experts on pediatric headaches.
To learn more, watch Headaches in Children: What Parents Need to Know, an online seminar by Dr. Oakley at http://bit.ly/18ggghh.