“Mom, I Have a Bad Headache, I’m Tired, and I Can’t Go to School”

David Rothner

in A Case a Week: Sleep Disorders from the Cleveland Clinic

Published on behalf of Oxford University Press

Published in print September 2010 | ISBN: 9780195377729
Published online April 2013 | e-ISBN: 9780199322985 | DOI:
“Mom, I Have a Bad Headache, I’m Tired, and I Can’t Go to School”

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Case 51 introduces a 15-year-old young man evaluated for chronic headaches, began without apparent precipitating cause, which were intitally occasional, nondescript, and of moderate severity. Over the subsequent 2 months, they evolved into daily headaches and then became 24/7. They were bifrontal in location, graded 5-6/10, and described as squeezing, worsened by activity, although not associated with nausea, vomiting, phonophobia, photophobia, or neurological features. He had never had a typical migraine. He had increasing difficulty with falling asleep, remaining awake until 2 to 3 a.m., and habitual delay in rise times on weekends, beginning before his contstant headaches, and had multiple nocturnal awakenings and increasing difficulty with getting up in the morning for school. No loud snoring, apnea, or abnormal leg movements were noted. The development of these sleep complaints worsened his headache and aggravated school issues.

Chapter.  1950 words. 

Subjects: Neurology ; Sleep Medicine

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