Migraine Headache in Children

• Migraine Headache in Children Overview
• Migraine Headache in Children Causes
• Migraine Headache in Children Symptoms
• When to Seek Medical Care
• Questions to Ask the Doctor
• Exams and Tests
• Migraine Headache in Children Treatment
• Self-Care at Home
• Medical Treatment
• Medications
• Next Steps
• Follow-up
• Outlook
• For More Information
• Web Links
• Synonyms and Keywords
• Authors and Editors

Migraine Headache in Children Overview

Migraine is a headache condition that comes back again and again. Ten percent of children get migraines, and an even higher percentage of teenagers have them. These headaches are very painful and throbbing, and children who have them often look ill and pale. Relief is usually linked with sleep. Doctors focus on ruling out other serious diseases or conditions when they first examine migraineurs (people who have migraines). Treatment consists of finding and avoiding trigger factors in the environment, giving immediate pain relief, and taking preventive drugs.

Migraineurs have various signs and symptoms. Typically, a child migraineur has a severe headache located around the eyes, in the front of the head, or in the temples. Some children experience vision changes ("auras") during a headache. A sick feeling in the stomach or vomiting is common. Many children avoid bright lights, loud noises, or strong odors, as these seem to make the headache worse. The severe head pain is often completely relieved by deep sleep. Recurring spells of dizziness may represent another form of migraine in children.

An inherited tendency is believed to make some people more likely to have a migraine after some minor trigger, although no single theory explains how the human body produces all the symptoms of a typical migraine headache. The key to recognizing migraines is identification of a pattern of short but very painful headache episodes that are relieved by sleep and separated by symptom-free intervals.

Although migraine headaches have long been considered a benign (relatively harmless) condition, they can cause a lot of damage to a person's quality of life and ability to take part in normal life activities. The pain is so intense that migraineurs often cannot think or function very well during or right after episodes.

About 65-80% of children with migraines interrupt their normal activities because of the symptoms. In one study of 970,000 self-reported migraineurs aged 6-18 years, 329,000 school days were lost per month. The burden of migraines may cause emotional changes like anxiety or sadness. Appropriate diagnosis and treatment of migraines can greatly improve quality of life.

Frequency

Studies suggest that migraine headaches occur in 5-10% of school-aged children in the United States, a percentage that constantly increases through adolescence and peaks at about age 44 years. Many people experience spontaneous remission, meaning that the headaches go away on their own for no clear reason.

Sex

Migraine headaches begin earlier in boys than in girls. From infancy to 7 years, boys are affected equally or slightly more than girls. The prevalence of migraines increases during the adolescent and young adult years, during which 20-30% of young women and 10-20% of young men experience migraines. After menarche (the name for the time when the first menstrual period occurs), a female predominance occurs. This continues to increase until middle age. The frequency of migraines declines in both sexes by age 50 years.

Age

Most migraineurs begin to experience attacks before turning 20 years old. Approximately 20% have their first attack before their fifth birthday. Preschool children experiencing a migraine attack usually look ill and have abdominal pain, vomiting, and a strong need to sleep. They may show pain by irritability, crying, rocking, or seeking a dark room in which to sleep.

Migraineurs aged 5-10 years experience headache, nausea, abdominal cramping, vomiting, photophobia (sensitivity to light), phonophobia (sensitivity to sound), osmophobia (sensitivity to smells), and a need to sleep. They usually fall asleep within an hour of the time the attack starts. The most common accompanying symptoms include paleness with dark circles under the eyes, tearing, swollen nasal passages, thirst, swelling, excessive sweating, increased urination, and diarrhea. Older children tend to present with headache on one side. Many sinus headaches are really of migrainous origin. The headache location and intensity often changes within or between attacks.

As children grow older, headache intensity and duration increases, and migraines start to happen at more regular intervals. Older children also describe a pulsating or throbbing character to their headaches. Headaches often shift to the one-sided temple location that most adult migraineurs report. Childhood migraines often stop for a few years after puberty.

To young children, nonheadache symptoms may be more troubling than the headache. Younger children may experience photophobia and phonophobia without accompanying stomachache or headache. Some children have repeated bouts of stomach pain without accompanying headache.

Migraine Headache in Children Causes

The exact cause(s) of migraine headaches is unknown. Some migraines are thought to be due a temporary deficiency of the brain chemical serotonin. Many of the drugs effective in treating migraines target this chemical. Some migraineurs know that their headaches are triggered by something they eat or drink or do. Most know who they are and what it is. The most common triggers are alcohol, chocolate, cheese, nuts, shellfish, Chinese food, sugar, and caffeine. Migraines most likely have several trigger factors and multiple internal causes. Although many migraine disorders do not develop until middle age, early recognition of migraine risk factors may help a child adopt a healthy lifestyle.