By Louis Neipris, M.D., Staff Writer, myOptumHealth
Your normally bouncy, active child is now curled up in a ball in the dark bedroom crying, complaining his head hurts. It’s been happening a couple of times a month. It lasts a few hours and seems to be better after a nap. But you are worried. You call your doctor.
After checking your child over, the doctor says that your child might be starting with migraines. You always thought of migraines as the scourge of adults. You and your sister both get migraines. But kids can get them too. Migraines affect from 3 percent to 10 percent of children. They are more common in adolescence.
For adults, migraines mean lost work days, chores left undone and all noise-related activities banished. But at least as an adult, you can put words to your pain. Children often can’t describe their symptoms, which can make it tough to diagnose migraine.
What is a migraine headache?
A migraine is a recurrent intense headache. It often comes with other symptoms, such as nausea, vomiting or sensitivity to light, noise or smell. It’s different than a tension headache, which usually has no other symptoms. A migraine can go away within a half hour or last for hours, even days. Attacks may follow triggers, such as stress or menstruation. For example, your son may get a migraine before a big game, or your daughter may have headaches around her period. About 15 percent of migraines come with an aura – blurriness, seeing spots, flashing, or colored lights – minutes before the headache.
What causes migraine?
The exact cause of migraine headaches is not known, but there is a genetic link. Migraines tend to run in families.
What are some of the typical symptoms of migraine headache?
- Moderate to severe throbbing pain
- Pain on one side or both sides of the head
- Sensitivity to light and/or sound
- Nausea with or without vomiting
- Pain that may get worse with daily activities
- Pain often relieved by sleep
- Aura may or may not be present
When should I see the doctor?
Make an appointment to see your doctor if your child has been having headaches.
Seek emergency medical care right away if the headache:
- Is the worst he or she ever had
- Is not getting better despite treatment
- Is accompanied by:
- Persistent nausea and vomiting
- Stiff neck and or high fever
- Personality changes or confusion
Doctor visit for your child’s headache
The doctor will rule out any dangerous causes for your child’s headache, such as infection or brain tumor. The doctor will take a history and do a complete physical exam, including a neurological exam. Tell your doctor about:
- When your child first started having headaches
- The headache pain (throbbing, squeezing, stabbing or other description)
- Any aura symptoms
- Symptoms during the headache (nausea, vomiting)
- What relieves the headache or makes it worse
Your doctor may ask for an imaging test, such as a head CT scan or MRI if the cause of the headache is not clear.
Keep a headache diary
If migraine headache is suspected, then your doctor may ask your child to keep track of his/her headaches with a headache diary. Write down when the pain began and how long it lasted. Your child also notes triggers:
- Staying up late
- Weather changes
- Skipping meals
- Certain foods
You help your child identify triggers, avoid them and help keep headaches at bay.
Treatment for migraines
If your child has been diagnosed with migraines, and symptoms set in:
- Give your child whatever medication your doctor suggested or prescribed as soon as possible. Giving the medicine early on may help to abort the headache.
- Settle your child down in a dark, quiet cool room and let him or her sleep. Sleep often helps relieve migraine. A cool wet cloth on the forehead may also help.
Medications for symptoms:
- Your doctor may recommend ibuprofen (such as Motrin), acetaminophen (such as Tylenol) or naproxen (such as Aleve) for your child. Don’t give your child aspirin if he or she is under the age of 20. Aspirin has been linked to Reye’s syndrome, a rare but potentially fatal condition.
- For teens, your doctor may prescribe migraine-specific medications called triptans. Although not approved for use in children, studies show that these medications may be safe and effective in certain cases. Your doctor may also prescribe anti-nausea medications if needed.
Medications to prevent migraines:
If your child has more than three migraines a month or the headaches interfere with school or daily functioning, your child’s doctor may prescribe medications to reduce the frequency of migraines and the severity of attacks. Several types of medications can prevent migraines. These include certain antidepressants, anti-seizure drugs and medicines used to treat high blood pressure.
What else can I do to prevent my child’s migraine headaches?
Follow your doctor’s treatment plan. In addition to taking medications as directed, your doctor may also advise your child:
- To avoid foods that trigger migraine attacks
- To drink plenty of fluids, especially on hot days
- To avoid all caffeinated drinks
- To follow a regular sleep pattern
- Not to skip meals
- American Headache Society. Headaches in children. Accessed: 03/09/2009
- Lewis DW. Headaches in children and adolescents. American Family Physician. 2002;65(4):625-632. Accessed: 03/09/2009
- Emrick L. Migraine Headache. In: Custer JW, Rau RE, eds. Johns Hopkins: The Harriet Lane Handbook, 18th ed. Philadelphia, PA: Elsevier Mosby; 2009.
- National Headache Foundation. Headache in children. Accessed: 03/09/2009
- Report of the American Academy of Neurology. Practice Parameter: Pharmalogical treatment of migraine headache in children and adolescents. Accessed: 04/03/2009