Migraine is a type of recurring headache that involves blood vessels, nerves, and brain chemicals. Sensations called auras may come before a migraine. Auras can include visual changes or numbness and tingling. There are two types of migraines: Migraine occurring with an aura (formerly called “classic”)Migraine occurring without an aura (formerly called “common”)
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Migraine headaches can affect a child’s performance in school, relationships with friends and family, and other factors in a child’s life.
The precise reason that a child is susceptible to migraines is unknown. Factors that may play a role include: Genetics and environmental triggersChanges in a nerve that serves as a major pain pathwayImbalance in brain chemicals, like serotonin
Factors that can trigger a migraine include: Physical exertion or too little physical activityToo much sleep or too little sleepMissing a mealMotion sickness from travelingTirednessOveruse of pain medicines
overweightSmokingCertain foods such as chocolate, citrus fruits, dairy, processed meats, or fried foodsCertain environmental triggers such as flashing lights, odors, loud noises, or weather changes
Factors that increase your child’s chance of migraines may include: Sex: More common in male children than female but more common in females after pubertyAge: average age a child may get a migraine headache is seven years old for boys and 10 years old for girlsHaving family history of migrainesInfantile colic
Migraines occur in phases that may include:
A warning may come before a migraine. In the hours or days before the headache, symptoms may include: A change in moodA change in behaviorA change in the level of activityFatigueYawningFood craving or decreased appetite
diarrheaSensitivity to light
The most common aura is visual. The aura lasts about 15-30 minutes. It may produce the following sensations: Flashing lights, spots, or zig zag linesTemporary partial loss of visionSpeech difficultiesWeakness in an arm or legNumbness or tingling in the face and hands
Migraine pain starts within an hour of the aura ending. Symptoms include:
A headache (usually on one side but may involve both sides) that often feels:
Moderate or severe in intensityThrobbing or pulsatingMore severe with movement Nausea or vomitingSensitivity to light or soundLightheadedness or dizziness
Migraines usually last from 4-72 hours. They often go away with sleep. After the headache, your child may experience: Trouble concentratingFatigueSore musclesIrritabilityMood changes
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Your child may also be given a neurological exam. The diagnosis is often based on your child's symptoms. To rule out other complications, your doctor may order imaging tests such as: CT scanMRI scan
The doctor may order blood tests or other tests before starting treatment.
Migraine therapy aims to: Prevent headachesReduce headache severity and frequencyRestore your child’s ability to functionImprove your child’s quality of life
Treatment options include:
Medicines often used as first line agents in children with headaches include:
Nonsteroidal anti-inflammatory drugs (NSAIDs) like
Note: Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of
. Ask your doctor which other medicines are safe for your child.
Your doctor may also recommend migraine medication.
Therapy may also be used to reduce the length and frequency of migraine headaches. It may be used with or without medication and may include cognitive behavioral therapy, biofeedback, or relaxation methods.
To help your child during a migraine: Apply cold compresses to painful areas of your child’s head.Have your child lie in a dark, quiet room.Try applying constant gentle pressure to your child’s temples.Try to help your child fall asleep.
Keep a diary to understand what factors may trigger your child's migraines.
Some steps that may help prevent future migraines includes: Have you or your child keep a diary. It will help identify what triggers migraines and what helps relieve them.Maintain regular sleep patterns, even during the weekend or on vacation.Learn stress management and relaxations techniques.Do not skip meals.Exercise regularly.
Foods are not proven to trigger migraine, but consider keeping track of what your child eats. Foods suspected by some to trigger migraine include:
Nuts and peanut butterBeans (eg, lima, navy, pinto, and others)Aged or cured meatsAged cheeseProcessed or canned meatCaffeine (intake or withdrawal)Canned soupButtermilk or sour creamMeat tenderizerBrewer's yeastAvocadosOnionsPicklesRed plumsSauerkrautSnow peasSoy sauceAnything with MSG (monosodium glutamate), tyramine, or nitrates
Since the cause of migraines is unclear, there are no steps to prevent your child's predisposition to migraines.
8/27/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
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: Bruijn J, Locher H, Passchier J, Dijkstra N, Arts WF.
Psychopathology in children and adolescents with migraine in clinical studies: a systematic review.
1/2/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Powers SW, Kashikar-Zuck SM, et al. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA. 2013 Dec 25;310(24):2622-30.
1/2/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Huquet A, McGrath PJ, et al. Efficacy of psychological treatment for headaches: an overview of systematic reviews and analysis of potential modifiers of treatment efficacy. Clin J Pain. 2013. Jul 2.
Last reviewed September 2013 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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