Patient education: Migraine in children (The Basics)

What is migraine? — This is a condition that involves a headache as well as other symptoms.

Migraine can affect both adults and children. Migraine headaches, or "attacks," often start mild and then get worse.

What are the symptoms of migraine in children? — The symptoms can be different based on the child's age:

●In toddlers, symptoms include suddenly getting very pale, being less active than normal, and vomiting.

●In young children, migraine attacks can cause nausea, vomiting, and belly pain. They can also make children sensitive to light and noise. The headache is often throbbing. It can affect the whole head or just parts of the head. For example, it might affect just the forehead or just the sides of the head.

●In older teens, the symptoms tend to be more like the symptoms adults get. The headache usually starts slowly, and usually affects only 1 side of the head. But in younger teens, both sides of the head are often affected.

No matter what age, most children feel better if they lie down in a quiet, dark room during a migraine attack.

Some children have something called a migraine "aura." This is a symptom or feeling that happens before or during the migraine attack. The aura usually lasts a few minutes to an hour and then goes away.

Each child's aura is different, but in most cases, it affects a child's vision. During an aura, a child might:

●See flashing lights, bright spots, or zigzag lines

●Lose part of their vision

●Have numbness and tingling of their lips, lower face, and fingers of 1 hand

Many children get symptoms of migraine that happen several hours or even a day before the headache. Doctors call these "premonitory" or "prodromal" symptoms. The most common are:

●Fatigue

●Irritability

●Paleness of the face

●Shadows under the eyes

Some teens get migraine attacks every month, around the start of their period. These are called "menstrual migraine attacks."

Will my child need tests? — Probably not. Your child's doctor or nurse will do an exam and ask about their symptoms. This is usually enough for them to tell what is causing your child's headaches.

If a doctor thinks that your child might have a serious problem, they might order an imaging test such as an MRI or a CT scan. These create pictures of the inside of the body.

How are migraine attacks treated in children? — There are lots of prescription and non-prescription medicines that can ease the pain of migraine attacks.

There are also prescription medicines that can help prevent migraine attacks from happening. The right medicine for your child depends on how often they get migraine attacks and how severe they are. If your child gets attacks often, work with their doctor to find a treatment that helps.

If your child has migraine attacks often, do not try to manage them on your own with non-prescription pain medicines. Giving non-prescription pain medicines too often can cause more headaches later.

Some types of behavior therapy might help to prevent migraine attacks in some people. An example of this is relaxation exercises. However, these might not help young children, and health insurance might not pay for them.

How can I help when my child has a migraine attack? — You can:

●Have your child rest in a quiet, dark room with a cool cloth on their forehead.

●Encourage them to sleep.

●Give them only the medicine or medicines you have talked about with their doctor.

Can migraine attacks be prevented? — Sometimes. Some people find that their migraine attacks are triggered by certain things. Common examples include stress, skipping meals, not drinking enough fluids, and sleeping too much or too little. If you can figure out what triggers your child's headaches, you might be able to help them avoid those triggers.

To find possible triggers, keep a "headache diary" for your child. Write down every time they have a headache, along with:

●The times it started and ended

●Where in the head the headache was – For example, left side, right side, both sides, or behind the eyes.

●How the headache felt – For example, "pounding" or "sharp."

●What your child ate and did before the headache started

●What you did to try to help – For example, having your child rest in a quiet, dark room.

●What, if any, medicine you gave, including the name of the medicine and the dose

●Any other symptoms your child had with the headache – For example, seeing flashing lights.

After keeping a diary for a while, check if there are any foods or events that seem to bring on an attack. Then, try avoiding those triggers to see if attacks happen less often. Share the diary with your child's doctor or nurse. It can help them understand your child's headaches and choose the best treatment for your child.

It might help to make sure that your child has:

●Good sleep habits

●Regular meal schedules

●Regular exercise

When should I call the doctor? — Call the doctor or nurse right away (without giving any medicine) if your child has a headache that:

●Starts after a head injury

●Wakes them up from sleeping

●Is sudden and severe

●Happens with other symptoms, such as:

•Vomiting

•Neck pain or stiffness

•Double vision or changes in vision

•Confusion

•Loss of balance

•Fever of 100.4°F (38°C) or higher

These things might be signs of a more serious type of headache. However, nausea, vomiting, and vision changes can occur with a migraine attack.

You should also take your child to see a doctor or nurse if:

●They have symptoms that could be a migraine attack.

●A headache and:

•Get headaches more than once a month

•Are younger than 3 years old

More on this topic

Patient education: Headaches in children (The Basics)
Patient education: Migraine in adults (The Basics)
Patient education: Abdominal migraine (The Basics)
Patient education: Botulinum toxin injections (The Basics)

Patient education: Headache in children (Beyond the Basics)
Patient education: Migraine in adults (Beyond the Basics)