Migraine is far more than a headache, infinitely more complex, and will have much more impact on life in general.

Migraine is actually a neurological disorder. The headache itself is one phase of a an attack of the disorder. Migraine is a genetic disorder. If a parent has migraine, a child has a 50% chance of inheriting it. For many years, the predominant theory was that migraine attacks were caused by the dilation and constricting of blood vessels in the brain. While scientists still accept that theory as the cause of the headache pain, it is no longer the predominant theory of the cause of the actual migraine attack. Advances in imaging technology now allow scientists to observe the brain during a migraine attack. This technology has led to the discovery that migraine sufferers have unusually excitable brain nerve cells (neurons). When a migraine is triggered, those neurons suddenly fire electrical pulses that ripple from the back of the brain, across the top, then back down to the brainstem where vital pain centers are located. This "wave" causes blood flow to increase drastically, then quickly drop off again. The pain of migraine is caused by the blood vessels inflamed by the swings in blood flow, brainstem stimulation, or both.

The Phases and Symptoms of a Migraine Attack:
Migraine attacks can have up to four phases. Not everyone experiences all of the phases, and even those who do may not experience all of them with every attack.

• The prodrome can begin up to two days before any headache pain begins. Only 30 - 40% of migraineurs experience prodrome. For those who do, it can serve as a kind of "yellow light," a warning that an attack has begun. For some, taking abortive medications at this point, can sometimes prevent the headache phase. Symptoms of prodrome can include:
  • food cravings
  • constipation or diarrhea
  • mood changes — depression, irritability, etc.
  • muscle stiffness, especially in the neck
  • fatigue
  • increased frequency of urination
• The aura phase is experienced by only 10 - 15% of children with migraine. The aura generally begins very quickly. It usually lasts from 10 to 60 minutes. The visual aura symptoms are most common, and can be very frightening. Again, for those who do experience it, it can serve as a warning, and an opportunity to take medications and possibly avoid the headache phase. Aura can manifest itself in several different ways:
  • visual: flashing lights, wavy lines, spots, partial loss of sight, blurry vision
  • olfactory hallucinations — smelling odors that aren't there
  • tingling or numbness of the face or extremities
  • difficult finding words and/or speaking
  • confusion
  • vertigo
  • partial paralysis
  • auditory hallucinations
  • decrease in or loss of hearing
  • reduced sensation
  • hypersensitivity to feel and touch
• The pain of the headache phase of a migraine attack may be moderate, but it can be very extreme and frightening to both the child and the parents. In adults, it is more common for the pain to be on one side of the head, but with children, it is very common for the pain to be in the forehead. It is seldom in the back of the head. Other common symptoms and characteristics of the headache phase include:
  • nausea and vomiting
  • sensitivity to light and sound
  • sensitivity to strong odors
  • dizziness
  • This phase usually lasts from one to 72 hours. In less common cases where it lasts longer than 72 hours, it is termed status migrainosus, and medical attention should be sought.
  • The pain is worsened by any physical activity.
  • diarrhea or constipation
  • nasal congestion and/or runny nose
  • depression, severe anxiety
  • hot flashes and chills
  • confusion
  • The child will probably want only to find a quiet, dark place and sleep

• The Postdrome
  Once the headache is over, the migraine episode is still not over. The postdrome (sometimes called postheadache) follows immediately afterward and may last up to two days.  In cases where prodrome and/or aura are experienced without the headache phase, the postdrome may still occur. During this stage, the child will probably be listless and perhaps lack his or her usual level of concentration.

Abdominal Migraine
Although unusual, a small percentage of children with migraine don't experience the headache pain, but have abdominal pain and more vomiting than is usual with migraine. This has been termed abdominal migraine. Children with abdominal migraine general develop more traditional migraine as adults.

Migraine Triggers
Migraine attacks are generally caused by one or more external triggers. Identifying these triggers and avoiding them is one way to avoid future attacks. Some common triggers are:

• foods:
  • aged cheeses
  • MSG
  • caffeine
  • chocolate
  • for a complete list as well as more information on identifying food triggers, see this review of The Headache Prevention Cookbook
• too little or too much sleep
• missed meals
• hormonal changes (females)
• barometric changes

Migraine Treatment
Over-the-counter analgesics, such as ibuprofen and acetaminophen may be helpful for the pain associated with migraine. Antiemetics, such as Phenergan and Compazine, are often prescribed to stop the nausea and vomiting. A helpful side effect of these drugs is that they generally make children sleepy, making it easier for them to sleep through an attack. In some cases, mild sedatives may also be prescribed. 

For teenagers, abortive drugs called triptans are often prescribed. These medications aren't pain killers. They work instead to stop the cause of the migraine attack. These drugs include Imitrex, Zomig, Maxalt, and Amerge. Low doses of triptans are sometimes prescribed for children over ten. In general, efforts are made to avoid narcotic pain relievers for children, but they are prescribed for teenagers if necessary.

For children who experience frequent migraine attacks, preventive medications may be prescribed to reduce the number of attacks. Some of the medications used for migraine prevention are:

• beta blockers (Inderal)
• calcium channel blockers (Calan)
• antidepressants (Elavil, Paxil)
• anticonvulsants (Depakote, Neurontin, Topamax)

Want to read more about migraine?
Check out Anatomy of a Migraine

Next page > Other Kids' Headaches > Page 1, 2, 3, 4

© 2001, Teri Robert
About, Inc.