Migraine Headaches

Many people suffer from migraine [MY-grayn] headaches, including children. About 12 percent of people U.S. experience migraines, according to the National Institute of Neurological Disorders and Stroke (NINDS) at the National Institute of Health (NIH). The number is much lower for children: Migraines affect about 1.5 percent of children by age 7, but that increases to about 5 percent of children and teens by age 15.

What Causes a Migraine?

Migraine headaches can cause pain that lasts 4 to 72 hours. Your child may describe moderate to severe pain on one side of the head that feels like a throbbing or pulsing. Headache pain can be worsened by:

• Noise
• Bright light
• Odors or smells
• Routine physical activity
• Coughing or sneezing

Migraines frequently happen in the morning, often on waking, or sometimes at predictable times, such as after a stressful week at school or before a girl’s period. For children before puberty, migraines affect boys more often than girls. After puberty, migraines are more likely to affect young women.

What can trigger a migraine in your child? It is different for each person, but some common triggers include:

• Sleep irregularities
• Motion sickness
• Strong smells
• Low blood sugar or a missed meal
• Changes in the weather or environment
• Stress
• Loud noises
• Emotions
• Tobacco smoke
• Missed dose of medicine
• Bright lights
• Hormonal changes
• Emotional issues such as depression or anxiety
• Head trauma
• Some medicines

Some foods such as alcohol, caffeine, aspartame, chocolate, aged cheese, cured meats, pickled foods, some fruit and nuts, and monosodium glutamate (MSG)

Types of Migraine

There are two main types of migraine: migraine without aura and migraine with aura.

• Migraine without aura is the most common form of migraine in children and adolescents. It involves headache pain that happens without warning. Your child may have pain on one side of the head with confusion, blurred vision, mood swings, fatigue, and nausea. They will probably also have increased sensitivity to noise, light, and sound.
• Migraine with aura begins with visual disturbances or other symptoms that can happen up to an hour before the onset of the headache. These symptoms usually only last for a few minutes, and they may happen without headache pain. Your child may lose all or part of their vision during this time. They may also experience numbness or muscle weakness on one side of their body, a tingling sensation in their hand or face, confusion, nausea, loss of appetite, and increased sensitivity to noise, light, and sound.

  Migraine Phases

  Your child may go through different stages during a migraine attack.

• Premonitory [pri-MON-i-tawr-ee] symptoms: These occur up to 48 hours before a migraine and include uncontrollable yawning, fluid retention, increased urination, food cravings, and mood swings.
• Aura: Your child may describe visual disturbances and seeing things like heat waves or flashing or bright lights. Some people have muscle weakness or the feeling of being touched.
• Headache: Migraine headache often builds in intensity over time. However, it is possible for your child to experience a migraine without head pain.
• Postdrome: After the headache, your child may be confused or exhausted for up to a day.

Ask your child about their symptoms, then discuss them with your child’s health care provider so they can determine if the issue is migraine or other another reason for recurring headaches. Keep a “headache diary” where you record details such as:

• Severity/intensity of pain
• Type of pain
• Location of pain
• Duration of pain
• Any other symptoms
• What medications were taken
• What you/your child did that provided relief from symptoms

Unfortunately, it is not known exactly what causes migraines. There is some evidence that migraines are inherited (passed down through families). Children who get migraine headaches may be sensitive to certain triggers, such as bright lights, weather changes, and so on.

Migraine also frequently occurs in children who have other medical conditions, such as bipolar disorder, depression, anxiety, epilepsy, and sleep disorder. Because it seems to also be influenced by hormones, migraine in teen girls may be related to their menstrual cycle.

The most important part of the diagnosis is a history of migraine attacks and symptoms. When or right after your child has a migraine, record their symptoms so you can discuss them later with the physician. The physician will ask about the medical history of your child, including a family history of migraines, and then do a medical exam and neurological tests.

If your child is having a migraine headache, you can help treat the symptoms and perhaps lessen the severity of the migraine attack by having your child:

• Nap (or rest with eyes closed) in a quiet, dark room
• Drink plenty of fluids, especially if the migraine is accompanied by vomiting
• Lie with a cool cloth or ice pack on their forehead

You can also use over-the-counter headache medicines such as ibuprofen or acetaminophen, or offer migraine medications as prescribed by your child’s doctor. Sometimes taking a little caffeine at the beginning of a migraine can help stop it from getting worse. 

Talk to your child’s doctor about preventive therapy, which can lessen how often and how strong the headaches are when your child gets one. There are many drugs approved by the U.S. Food and Drug Administration (FDA) for headache treatments.

To prevent future migraine attacks, or reduce their severity, your child may need to take medication daily. This could include antidepressants, antihistamines, beta blockers, calcium channel blockers, anticonvulsant drugs, and nonsteroidal anti-inflammatory (NSAID) medications. Some drugs may cause side effects, so they should be monitored by a doctor.

Other non-medical interventions you can try with your child include things like practicing relaxation techniques and having a regular sleeping and eating schedule. And if you and your child can learn to recognize triggers, you may be able to prevent migraine attacks from happening in the first place.

What causes migraine [MY-grayn] in children? Migraine is a severe headache that’s accompanied by other symptoms, such as nausea and sensitivity to light, noise, smells, and sound. Record symptoms of your child’s migraine headaches so you can discuss them with your child’s doctor. They will make a diagnosis from your child’s medical history and neurological tests and help your child feel better in the future with medication or other interventions.