Children With Migraines

Most children will experience at least one headache before the age of 15 so it important for parents to understand how to help children with migraines. Most of these are caused by viral illnesses, such as a cold or the flu. Children can also get typical tension-type headaches as well. About 5% to 10% grade school children will get a migraine and up to 20% of adolescents will experience one. Prior to adolescence, boys will have migraines a bit more often than girls, but after puberty girls are nearly 3 times more likely to have migraine headaches. Although the treatment of headaches in children is fairly straightforward, diagnosis isn’t always as simple.

Symptoms to Look For

Children experiencing a migraine will often have the same classic symptoms adults have. This includes photophobia and phonophobia (light and sound sensitivity), throbbing pain in the forehead or around the eyes, and an aura. Nausea and vomiting seem to be more common in children with migraines compared to adults. Younger children are also more likely to have what are known and abdominal migraines. These are “headaches” where the child has abdominal pain with nausea and/or vomiting, but no actual pain in the head. The International Headache Society has developed criteria to help aid in the diagnosis of abdominal migraines.

Triggers in Children

Children have many of the same triggers as adults. Children seem to be especially sensitive to sleep, or the lack thereof. If your child deals with migraines, try to ensure he receives adequate rest. This can be a challenge given how busy children have gotten with school and other activities, but getting enough sleep can be a simple solution. Other triggers include:

• Strong or unusual odors, bright lights or loud noises
• Changes in weather or altitude
• Being stressed or depressed
• Changes in sleeping patterns or sleeping time
• Certain foods, especially those that contain tyramine, sodium nitrate or phenylalanine
• Missing meals or fasting
• Menstrual periods or hormones
• Intense physical activity

Treatment and Prevention in Children

Initial treatment for a headache includes allowing your child to lie down in a dark, quiet room while the headache passes. Sometimes a cool cloth over the forehead can also help. If these tactics aren’t working, acetaminophen (Tylenol) is a relatively safe medication to try. Be sure to check the label carefully for doses, and discuss proper use with your child’s physician.

Preventing migraine headaches before they start is a more effective strategy that will improve your child’s quality of life. Be sure your child eats regular, balanced meals. As a rule of thumb, children should not be skipping meals. Also ensure that your child is on a regular sleep schedule. This can become tricky as children become adolescents, but this is one of the most important things you can do for your child’s health. Keeping a headache journal to discover triggers such as stress, certain foods, or particular activities can help you avoid those things in the future.

If your child has regular, frequent headaches his doctor may prescribe a prophylactic medication to be taken either daily or at the beginning of an attack. This is a fairly rare solution for children, but may be the best way to control the problem.

_Sources:

Goldstein J, et al. “Diagnoses and symptom pattern in children presenting to a pediatric headache clinic.” Headache. 1993;33:497-500.

Lewis, Donald W., M.D. “Headaches in Children and Adolescents.” American Family Physician, Vol. 65/No. 4 (February 15, 2002).

Low-Tyramine Headache Diet. National Headache Foundation. Retrieved: August 22, 2008. http://www.headaches.org/pdf/Diet.pdf

Migraine Headache in Children and Adolescents. From the American Academy of Family Practice’s FamilyDoctor.org site. Retrieved: September 7, 2008. http://familydoctor.org/online/famdocen/home/children/parents/common/common/757.html