Pediatric+Headaches

TCM & kids
-Because of "delicate skin & muscle,: they "take chill easily" -Because of "flabby skin & muscle," the "transmit changes (infections) easily" -because of "sensitive stomachs," they "spit up food and milk easily" -Because of "weak organ vitality", they "easily gain and lose weight" -Because of "listless spirit", they "easily become emotional" -Because of "fetal poisons collected", they are "more susceptible to measles and pox" -Because of "weak meridians" they"easily become spastic" -Because of "weak (cardiopulmonary) vitality", they "easily become chilled and feverish, hungry and full..."

Special Factors in the Treatment of Children
-Children are excess wood/fire & deficient earth/metal/water 2. Children are susceptible to external pathogens 3. Children have weak digestive function 4. Children produce phlegm easily 5. Children tend toward excess yang and deficient yin 6. Children inherit fetal toxins 7. Children are highly susceptible to emotional stress 8. Children are prone to convulsions 9. Children depend on kidneys for growth and development 10. Pathogens easily become entrapped in children

Kids and headaches Prevalence: -40% of preschool children -up to 70% of school age children

Classified as acute or chronic Acute: mostly due to viral illnesses, sinusitis, mild head trauma, & occasionally CNS abnormalities Chronic: majority in school-age kids are idiopathic and pain is the main symptom. In a small percentage of kids the headaches are a secondary symptom of the medical condition, such as hypoglycemia Types of idiopathic headaches include: migraines and tension-type headache Key factors related to idiopathic headaches: -Stress - most frequently cited factor -Weather and environment -Food sensitivities

Types of headaches There are many causes & types of headaches Acute/External Patterns include:

1. Wind-Cold
stiff, achy neck and back pain, aversion to wind/cold, clear nasal discharge T: pale w/ normal coat

2. Wind-heat
severe, splitting headache, aversion to wind/heat, flushed face, thirst, fever, yellow-green discharge, dry stool, yellow urine T: normal-red w/ yellow coat

3. Phlegm/Wind-Damp
fuzzy/muzzy head, droopy eyelids, nausea, vomiting sputum, chest oppression, epigastric pain/fullness, loose stools T: greasy coat

4. Blood Stasis-Trauma
-injuries are responsible for more pediatric deaths than all other causes combined -Hundreds of thousands of kids are seen in ER for head trauma -Usually brief/no loss of consciousness and no neurological complications -However some injuries include skull fractures, hematoma, contusions, and seizures -Obstructions of collaterals by blood stasis resulting from head trauma or long-standing pain. Stabbing, splitting, localized intermittent but lingering headache T: purple spots P: choppy

Chronmic/Internal Headache -Chronic, recurrent headaches are due to impairment of Qi & Blood flow -Various causes include: stress, emotional excesses, dietary imbalances, constitutional weaknesses

Six important categories of information for assessing chronic/internal headaches: 1. Location 2. Characteristics: Yang or Yin type 3. Relations to food 4. Association with emotions/organs 5. Initial episode that precipitated headache 6. Evolution of headache

Taiyang Headache -Occurs along the Bladder channel -May begin w/ internal invasion which becomes lodged in the channels -May resemble a tension headache as the back of the neck muscles remain contracted from cold -Tension headache account for 1/3 of childhood headaches

Shaoyang Headache/Migraines -occur on lateral side of neck/head -Considered most common childhood headache, up to 54% of all pediatric headaches -Triggered by emotional upset, stress, lack of sleep, sensory stimulation, and physical exercise -Sometimes preceded by visual/sensory aura -Throbbing, bilateral or unilateral pain -LR organ pathology: LR Yang/LR fire -Typical LR Yang rising headache: classic migraine of intense, throbbing, pulsing pain along GB channels to temples or behind eyes -May involve nausea/vomiting due to LR Qi invading ST affecting normal downward movement -Often involves emotional attacks: LR Yang excess-anxiety, anger, frustration, resentment or KI Xu- fear, paranoia

Yangming Headache -Frontal Headache -Often associated w/ sinusitis -Usually seen in older children -Can be due to dietary issues -May be caused by ST heat (fried, spicy food), ST Qi stagnation (overeating), or ST Yin xu (due to irregular or late eating)

Taiyin Headache -characterized by a heavy, tight sensation as if wrapped by a band, usually dull achy pain -Due to SP Qi xu w/ damp accumulation in the head -May be accompanied by other SP Qi xu signs: fatigue and digestive issues -Chronic over-weight or the habitual consumption of sweet and fatty foods -Can also occur with excess mental stress or pressure, busy schedules with inadequate rest

Shaoyin Headache

Pediatric Tuina Basic H/A sequence 1. Press and rotate "two leak doors" (two depressions on back of hand) 2. Press rottate "union valley (LI-4) 3. Press rotate "brain hollow" (GB-19) 4. Grasp "wind pond" (GB-20) 5. Push "celestial gate" midline of the forehead 6. Push "water palace" (YuYao) 7. Press rotate (lightly) "great yang" (Taiyang)

wind-cold (medium ginger/scalliontea) 1. press rotate" one nestful wind" back of hand @ midpoint on wrist crease) 2. Press rotate "small celestial center" (Palm crease)

wind-heat 1. Push (clear) "lung meridian" (4th finger) 2. Press rotate "kidney line" (root of 5th finger) 3. Push "water of galaxy" (midline inside of forearm, from wrist to elbow)

Phlegm/Wind-Damp: 1. Press rotate "external palace of labor" (Center of back of the hand) 2. Press rotate "spleen meridian" (pad of thumb) 3. Push then press rotate "small transverse lines" (palm side creases of all five fingers)

SI-17 reduced inflammation of the blood vessels