A child's symptoms are frequently labeled psychosomatic if no objective data on physical examinations, x-rays or lab tests is discovered. Often, a significant number of children who complain of these central nervous system symptoms have a physical basis for their problems. Pediatricians and physicians should listen to what both a parent and a child has to say without prejudice and not be afraid to use common sense and clinical judgment to figure out the underlying reason for a subjective complaint. In order to clearly detect whether there is a physical reason for a child's medical complaints, it is imperative for any physician to take a comprehensive medical history, starting as early as a child's prenatal development and behavior. This history should detail the symptoms that have occurred over the child's lifetime, including a review a history of infections. The relationship between the parent and the pediatrician should be a partnership because a parent is often the best judge of his or her child's behavior and medical complaints. Once a complete medical history of both the child and family is obtained, a complete physical examination should be carried out and then only pertinent lab work for the patient's symptoms is ordered to rule out medical causes other than allergies. Once this initial evaluation is done and other causes are ruled out, frequently allergy testing should be recommended based on the child's medical history. My approach is to test-if indicated-pollens, molds, foods, additives, and chemicals. Foods and molds tend to have the greatest adverse impact on the central nervous system and often produce a positive result in allergy testing that correlates with these types of complaints. Over the past eight years, I have seen an incredible number of children with subjective central nervous system complaints who do indeed have a physical basis for their problem and who exhibit hypersensitivities to pollens, molds, chemicals, additives, and foods.

A classic example involves a child with severe migraine headaches who I treated ten years ago. The child had been examined by an excellent pediatric neurologist who diagnosed the child's symptoms as psychosomatic. The child subsequently came to visit my office and underwent a complete examination. The answer we found was not psychosomatic..it was peanut butter. The identification of a food allergy as the cause of this boy's migraines enabled him to eliminate peanut butter from his diet and resolve the migraines.

Parents, under the controlled supervision of a pediatrician or family physician, can try an elimination diet at home to help determine if their child is truly being affected by allergies. There are several approaches to an elimination diet. The simpler approach is for a parent to select one particular food the child craves or ingests frequently. For example, eliminating milk for seven to 10 days and then reintroducing it into the diet may provoke a number of physical complaints from head to toe.

The most common complaints are abdominal symptoms and central nervous system symptoms such as irritability, fatigue, mood swings and hyperactivity. A more complex approach is the multi-food elimination diet. This involves eliminating milk, wheat, corn, sugar, chocolate, citrus, peanuts, preservatives and additives for approximately two weeks. During this two-week period, the child should eat primarily fruit, vegetables, chicken, turkey, fish, rice and water. After the 14-day period of diet elimination is complete, one food is added back into the diet every one to two days as a food challenge to see if symptoms are provoked. If an adverse reaction to a food occurs, chances are one of the cause of the child's medical complaints has been found. Elimination diets can be very frustrating for both the parent and the child but they provide an effective way to discover the root of an allergic problem. Parents should beware of the false sense of security that can often accompany a negative elimination diet. All too frequently, the problem can be a food eaten on a regular basis but is usually considered a highly nutritious food such as a fruit or vegetable. Parents may then want to do another elimination diet for other foods in the diet--not just common ones.

A child's treatment involves the use of sublingual immunotherapy based on the allergy test results. Sublingual immunotherapy is essentially a homeopathic treatment; it involves the detection of each allergen and the subsequent development of a treatment comprised on allergen dilutions to block adverse reactions. Sublingual immunotherapy is an often effective treatment for foods, molds, chemicals and pollens that are causing a child's multiple complaints, especially those associated with the central nervous system. In addition to immunotherapy, I often recommend that parents make dietary adjustments which include limiting foods such as milk, sugar, baked goods and junk food. If necessary, this dietary restriction can be more restricted or more flexible based upon each family's preference and the individual needs of the child. A child's unresolved medical complaints can cause endless worry and frustration for a parent. If the child is suffering from central nervous system complaints such as headaches and hyperactivity, it may not merely be an emotional problem--an allergy could be the cause.