When you think of migraines, you probably imagine an adult experiencing severe, crippling head pain from time to time. But migraines aren’t a health problem that only affects adults. Children and teens can get them and they can be just as severe as they are for adults. In this article, we’ll provide you with the information every parent needs on how to treat pediatric migraines.
Symptoms of pediatric migraines
Pediatric patients often experience tension type headache pain as well as migraines. In fact, among children in the United States aged 5 – 17, “15% experience tension-type headaches and 5% are coping with migraines.”
Your child may not have the words to express what she is feeling. She is also likely unfamiliar with coping mechanisms adults use to relieve pain. If your child is struggling with pediatric migraines, your first stop might be the emergency department at your local hospital. It’s important to recognize the symptoms as well as the prevalence of migraine pain your child is experiencing. This can help you prevent them as well as manage them without those ER visits.
Those symptoms include:
- headache pain lasting between 3 hours to 3 days
- stomach pain
- blurry vision
- light sensitivity
In children, a migraine’s effects may be less painful than in adults. However, other physical symptoms can be more severe.
If you have a child who is unable to describe her own symptoms, you may feel powerless in determining how to treat pediatric migraines.
Look for signs of migraine onset that include:
- grabbing his or her head
- loss of appetite
- sensitivity to light
- drastic mood swings
- constant yawning
There is one key way to predict the onset of a migraine. Before a migraine begins, many sufferers describe a type of premonition that they are about to happen. These are known as auras. Auras can take the form of:
- vision problems (such as sight loss, blind spots, or seeing shapes, colors, spots, or flashes)
- difficulty remembering words (aphasia), or slurred speech
- feelings of pins & needles types of sensations, or the feeling that a part of the body has fallen asleep
- temporary weakness in the limbs (hemiplegic migraines)
Auras last around an hour or less, getting worse with time. They can accompany the onset of a migraine headache.
Before the aura occurs, children may also go through a longer period of time (1-2 days) where they begin yawning uncontrollably or are more cranky, hyperactive, hungry or morose than usual. Complaints of stiffness/soreness in the neck are also common during this time. This period and auras may not occur in every child, but it’s important to remain vigilant for signs of them and to plan accordingly.
Want to know more about kids and adolescents are facing pediatric migraine pain? View this video
Diagnosing pediatric migraines
When children are very young, they cannot express themselves fully or have never experienced a migraine before, so pediatric migraines can be challenging to diagnose. But it’s crucial to their health and to their quality of life to get a proper diagnosis. When migraines are frequent, they can have an impact on a child’s school days and attendance and his or her engagement in extracurricular activities.
Your child’s doctor can diagnose pediatric migraines by following the criteria in the International Classification of Headache Disorders. In addition to going through the checklist, your health specialist should be skilled at recognizing sometimes subtle manifestations of signs of migraines.
For example, the criteria for diagnosing migraines without auras include:
- at least 5 attacks fulfilling criteria B-D (since 1 attack alone can be difficult to distinguish from migraine-like attacks).
- headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)
- headache has at least 2 of the following 4 characteristics:
- unilateral location in adults or may be bilateral in children.
- pulsating quality
- moderate or severe pain intensity
- aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)
- during headache at least 1 of the following:
- nausea and/or vomiting
- photophobia and phonophobia (sensitivity to light or sound – often inferred from behavior in children)
- not better accounted for by another headache-related diagnosis
There are several different diagnoses of migraines. This is why it’s important to speak to an experienced specialist before determining the best course of action for your child.
Causes of pediatric migraines
Both pediatric migraines and migraines in adults remain mysterious to doctors. But studies have suggested that they might be inherited (especially in hemiplegic migraines, where sufferers experience limb weakness).
This means that if a child’s parents suffer migraines that there is a much higher chance the child will experience them especially if the mother suffers from them. Approximately 3 out of 4 people who live with migraine pain are women. Additionally, adult migraines affect 4% of young women – twice the number of young men affected.
While the exact cause of pediatric migraines is unknown, some patients report triggers that may cause the onset of symptoms. Common triggers include:
- loud noises
- overconsumption of food additives
- unbalanced diet, overuse of medication
- chronic digestive disorders
- strenuous physical activity
How common are pediatric migraines?
According to the Migraine Trust, approximately 10% of the pediatric population suffers from true migraine headaches. About half of the sufferers experienced their first migraine before they reached age 12. Migraine headaches have also been diagnosed in toddlers as young as 18 months. Increases in prevalence jump from 3% at ages 3 – 7 to 8% to 23% at ages 11 – 15+ years.
While some children grow out of this experience, most do not. Many children and adolescents with migraine pain continue to struggle and live with it past the age of 30. This has sparked an interest in alternative forms of treatment of migraine headaches in children as well as in adults.
How to treat pediatric migraines
There is no miracle cure for pediatric migraines. However, there are some things you can do for your children to make their condition more comfortable. If your child can alert you when a migraine is starting, over-the-counter pain medication such as acetaminophen or ibuprofen is often effective.
Additionally, resting, turning off bright lights and avoiding loud sounds can help reduce the severity of migraine pain. For regular sufferers of migraines, a doctor can prescribe medication to help with the condition. These specific anti-migraine drugs are called triptans and can be taken when a migraine starts. The American Academy of Neurology found that triptans in the form of nasal spray are safe and effective for children and adolescents. They can help relieve pain in as little as half an hour.
Once acute or chronic migraine attacks are diagnosed, your child’s pediatrician may suggest a series of treatments.
Traditional biomedical therapy includes:
- dopamine receptor antagonists (DRAs)
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- combination therapies
Newer therapies you can discuss with your child’s pediatrician include:
- valproic acid (VPA)
- peripheral nerve blocks
- psychological treatment
- non-invasive brain stimulation
When managing migraines at home, it is important to determine what migraine triggers may be. If there are certain foods, stressors (environmental, mental or emotional), changes in environment, habits or diet that could help your child to feel more at ease, you should look to incorporate them.
Addressing the attack
When your child experiences a migraine attack, it is disruptive and stressful for both her and your family. The frustration and throbbing pain can make everyday life challenging while you try out quick and effective pain relief practices. After reading this guide, we hope you feel empowered on how to manage pediatric headaches in children of all different ages.
If you are unable to manage your child’s migraine at home, seek support from your health care team to determine if there is a diagnosable underlying cause of the discomfort.
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