Migraines in Children

A migraine is no ordinary headache. It’s a complex and often debilitating neurological disease. This intense, throbbing headache often occurs with other symptoms, such as nausea, dizziness, and sensitivity to light. Migraines can last from several hours to several days, making it impossible to function.

This problem doesn’t just target adults. Your child could be suffering from migraine headaches but you may not realize it.

What’s Behind Pediatric Migraines?

Migraines often start in childhood. Half of those with migraines experience their first attack before age 12, according to the Migraine Research Foundation (MRF). Some 10% of school-age children have migraines. By the time they’re 15 to 19 years old, 28% of adolescents suffer from migraines.

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Risk Factors For Migraines in Children

Scientists don’t yet know what causes migraine. Genetics and environmental factors may be partly to blame.

  • Your child has a 50% chance of inheriting the disease if one parent has migraines, according to MRF.
  • Your child has a 75% chance of inheriting the disease if both parents have the disease.

Signs and Symptoms

Migraines in children can often take longer to diagnose and treat. Adults can realize they’re experiencing something different than a headache. Your child may be too young or might have a hard time explaining what they’re feeling.

Migraine symptoms include:

  • Moderate to severe pain on one side of the child’s head (some can have pain on both sides)
  • Nausea
  • Vomiting
  • Dizziness
  • Sensitivity to light, sound, touch, or smell
  • Pain behind one or both eyes
  • Seeing flashes of light, spots or blind spots, or other vision changes (also known as migraines with aura or “classic migraine”)

Other signs to watch for in children also include:

  • Irritability
  • Mood or behavior changes
  • Depression
  • Fatigue or tiredness
  • Sleep disturbances
  • Difficulty concentrating

Children can also experience what’s known as anticipatory anxiety — anxiety caused by fear that a migraine may occur.

When Should You See a Doctor?

In general, children usually experience shorter and less frequent migraine episodes than adults. Your child also may experience chronic migraine (CM) — when a child has 15 or more headache days per month lasting more than 4 hours, for more than 3 months, according to the American Migraine Foundation (AMF).

You should see a doctor if your child:

  • Develops frequent or severe headaches
  • Takes any medication for headache more than twice a week
  • Has any migraine symptoms
  • Is awakened by a headache or experiences headaches in the morning upon awakening

Seek emergency care if your child:

  • Has a sudden “thunderclap” worst ever headache
  • Has altered mental status, confusion, or lethargy with a headache
  • Has fever and stiff neck with a headache

The AMF suggests keeping a headache journal. You should record:

  • Your child’s headache symptoms
  • How often headaches occur (frequency)
  • How long each headache lasts (duration)
  • Any triggers you can identify

This information can help your doctor in diagnosis and treatment.

Treatment For Migraines

Your child’s pediatrician or family doctor can help develop a treatment plan. They can also refer you to the Division of Child Neurology at UPMC Children’s Hospital of Pittsburgh.

Migraine treatment can include medications, behavioral therapy, nutritional or lifestyle changes, and prevention and coping strategies.

There are very few FDA-approved drugs for migraine prevention and treatment in children. Your doctor may use off-label drugs to prevent or treat your child’s migraines.

You can give your child over the counter pain medications, such as ibuprofen (Advil) or acetaminophen (Tylenol), to manage pain during migraines. Talk to your doctor about how often your child should take these drugs. Rebound headaches can occur so you want to be careful not to overuse them.

Healthy Habits

Identifying and preventing triggers is a big part of migraine treatment.

Healthy habits for migraine prevention recommended by the AMF include:

  • Getting adequate and consistent sleep each night
  • Staying hydrated throughout the day
  • Keeping snacks on hand and not skipping meals (low blood sugar can trigger migraines)
  • Exercising regularly to reduce stress
  • Eating more fresh food and less processed food
  • Decreasing caffeine intake, such as from sods, coffee drinks, and chocolate

Strategies to manage migraine pain include:

  • Resting in a quiet, cool, dark room
  • Sipping cold water
  • Placing a cold compress or cloth on the painful area

Migraines can interfere with your child’s daily life. And school day stress can contribute to their migraines. Your child’s doctor and school nurse can help your child develop a plan to manage migraines at school and during extracurricular activities.

Sources

Migraine in Schoolchildren: A Parent's Guide. American Migraine Foundation. Link

Pediatric Migraine: A Guide for Parents. American Migraine Foundation. Link

Laura Papetti. Prophylactic Treatment of Pediatric Migraine: Is There Anything New in the Last Decade? Frontiers in Neurology. Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh ranks No. 8 on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. All 10 of our specialties rank nationally. UPMC Magee-Womens Hospital is a longtime national leader for women and their newborns. We aim to provide the best care for your children, from birth to adulthood and beyond.