Migraine may affect kids slightly differently than adults. The head pain may affect the whole head rather than just one side.
Also, attacks in kids are shorter, and may last less than an hour but in most cases the pain may take anywhere between three and four hours to subside.
The headache may disappear with time, but kid may feel sick for days and this may be worse than head pain. In some cases this sickness actually marks the end of an attack and may bring some relief from all its symptoms.
- Often car sickness is a good indicator of migraine.
- There might be some abdominal pain and no head pain.
- This kind of headache can come on suddenly, and child may be in severe pain within 10-15 minutes.
Many childhood syndromes such as turning the head to one side for a few seconds and then again turning it back, vomiting in cycles, colic, and episodes of dizziness like the room is spinning can be predictors of migraine in later life.
Many teenagers may also experience:
- Sensitivity to noise and light
- A lack of energy
- Aura or disturbed vision may happen
Migraine symptoms often vary from child to child and sometimes it can even be different from one attack to the next. Many children who get attacks may experience them occasionally, while others may have them every week, or even every day. Some children may suffer attacks ever day for few weeks, but may then have no attack for months. Others may get migraine headaches in almost weekly or monthly pattern.
The headache in some may get worse with slightest physical activity. Sleep, even for a short duration, may help migraine to dilute and go away.
Around 14 percent of kids with migraine experience aura. They’re temporary symptoms, which include speech or eyesight disturbances, dizziness, feelings of tingling, limb weakness, or numbness. Eyesight aura can include blind, blurring spots, or maybe colored or dark spots, a pattern of flashing lights, zigzag lines, sparkles, or stars. Symptoms may last for up to one hour. Most of the children may also experience headache. In most adults, aura happens immediately before the headache, but in children it can happen simultaneously with the headhace.
How many children suffer from migraine?
Around 69 percent of school children experience headaches at least twice a year. One of the four of these children may suffer recurrent headaches, and about 12 percent of school children may suffer from migraine.
Migraine affects both girls and boys. About half of the sufferers will have had their first attack before their 10the birthday.
Parents usually want to know if their child will gradually grow out of this condition. There’s no simple answer to this particular questions. It has been observed in some studies that five out of eight childhood sufferers find their headaches have improved by the time they reach 20 years of age. Up to one quarter of all childhood sufferers had outgrown their condition completely.
Research suggests that proper childhood migraine management can definitely stop youngsters from becoming long term or frequent sufferers when they become adults.
Sometimes migraine can be unpredictable. Parents and children will learn from experience that some things can trigger attacks, but in some cases the influence of these triggers can be complicated. Sometimes a known trigger will bring on a migraine, whereas on some occasions it may not do so. This suggests that combination of factors may be necessary to trigger an attack.
Children usually carry out different activities in number of different environments and are often under pressure every day. It’s not possible that by setting up a regular routine and making certain arrangements, attacks can happen less frequently.
Common Migraine triggers include:
Not drinking enough liquids can trigger migraine especially in active children. If you want your child to drink regularly, it may mean asking permission from school to let your child drink water during class.
Some children may get attacks when their normal sleep pattern is disturbed. This may include having too less, or too much of sleep. Setting a regular time of going to bed or getting up may help avoid migraine attack developing.
Many people who get migraines try to avoid some foods, however, they can easily identify many other triggers that are easy to control and can help control migraine attacks with limited changes in their diet.
Often an oncoming attack can create a carving for certain kinds of foods. If that particular food is eaten it comes difficult to decide if the food immediately before the attack brought the attack, or if the attack was already starting.
If your child thinks a certain food is responsible for her migraine, it’s important to first establish whether this is the case by maintaining a trigger diary.
Children feel pressure from so many different things. It can come from exam worries, from other children, or from family issues. It’s not easy to manage stress, and you can definitely help by knowing about all these pressures. Your child will feel better when he or she knows they have someone to talk to. Gradually, child may learn ways to relieve stress and tension.
Lack of food
Insufficient food intake is the biggest dietary triggers. Eating sugar snacks, missing meals, especially breakfast, and avoiding balanced meals can all contribute to a migraine attack. Giving your child small nutritious snacks at regular intervals will help in limiting their attacks.
Try to speak to someone responsible at your child’s school about allowing them to snack few times outside the normal break time if long breaks between appears to be one of the triggers for your child.
You can’t avoid certain environments, such as changes in weather and bright lights that can trigger a migraine. However, it is very important to ensure that kids do not worry about all these situations because worrying can also cause an attacks, and it’s possible some of these environments can even become “learned triggers”.
Some children feel they get migraine around the time when they’re not feeling well for another reason. For instance, you’ll find your child gets migraine when they’re suffering from a stomach bug or a cold.
Many girls suffer migraine attacks at the start of their monthly period. If you feel these things trigger migraine in your child, you must do everything possible to avoid other trigger factors at these times can definitely help avoid an attack.
In some children, sudden exertion with intense physical exercise, such as running can immediately trigger an attack. It’s best to set up a routine of taking regular exercise, rather than avoiding it to stop attacks. Make sure your child has sufficient to drink before they start exercise as this can help reduce the trigger.
You should keep in mind that flicker and glare from your TV or computer screens can also trigger a migraine attack so encourage your child to take frequent breaks while working on the computer or while playing games.
How does migraine affect a child’s daily life?
Migraine can definitely have an enormous impact on a child’s life. Besides discomfort and pain of an attack, few migraine symptoms can be quite frightening, especially when your child experiences them for the first time. An attack can cause anxiety in the child and may have to miss certain activities. Some children may want to opt out of certain activities mainly because they’re frightened that it could bring on an attack.
Many children are sent home from school or may miss it altogether because of an episode of migraine. This can make a child feel “different” or frustrated. Their education also suffers especially if they find it difficult to catch up with their missed lessons. This can become a big problem when attacks start happening on regular basis.
Many children may experience “weekend migraine”, where the relaxation at the end of weekend brings about a attack. It can also affect even simple activities with family and friends, so in these circumstances a child may feel left out. Ultimately migraine may start affecting their social life which may even lead to a feeling of low self-esteem.
What’s the best way to support young migraine patients?
There are so many ways in which you can help your child cope with their migraine attacks. For example:
Record – Help identify triggers and learn ways to predict when a migraine attack is about to happen. Help your child maintain a headache diary. You should also help our child maintain a record of how they treat their migraine so that they know what all to do when they feel their attack is coming on. It’s useful to give this to school for emergency treatment in case child experiences an attack at school.
Reassure – It’s important to get your child diagnosed from a good doctor, and seek advice on how to treat and manage your child’s migraines.
Watch your child – Usually it’s possible to sense when your child is about to have a migraine attack. You can do this easily by recognizing some warning signs, which may occur 2-40 hours before the headache comes on. These may include:
Tiredness and yawning;
A child being quieter or more irritable than usual;
A pale complexion;
Encourage them– Your child may feel more confident about their condition if you help them in trying to manage it.
Support – It’s important to give extra attention to your child to catch up with missed schoolwork. It’s best to give a copy of this information to your child’s school or teacher.
Diagnosing migraine in children
Any child with headache should be seen by a doctor.
With right diagnosis:
- You will get peace of mind that child’s headaches are not a sign of some serious illness
- You get advice on managing, stopping and treating headaches
- Your child will feel reassured and will understand the situation
It’s not easy to diagnose migraine when a child has some linked symptoms that go with it, but have very short or mild headache. For instance, a child may feel really sick or have bouts of being sick. Complicating these diagnosis even more, there are different types of migraines, each with many unique symptoms that can happen in any child. The biggest thing to remember is that each child’s condition is unique.
As a parent, gather vital clues about your child’s behavior during a migraine attack. For instance, do they put themselves in their bed in a quiet room, or do they shy away from bright lights? Your child may get the feeling of sickness. Do they often complain of head pain and rub their forehead at the same time?
Sometimes migraines are confused with so many other conditions and in some cases a child may continue to suffer due to wrong diagnosis. In other cases, a parent of a child may suspect that a different condition is causing their headaches.
Mostly, migraines in children are mistaken for sinus disease. It’s common for people to misunderstand a change in the behavior of the child caused by a headache. For example, a teacher may think that child is faking headache to avoid school. Other common mistakes include blaming headaches on eyesight issues or allergies. If your child complains of headaches it’s important to immediately see a doctor. Once migraine has been diagnosed, it’s easy to rule out other causes. At this stage, you can reassure your child that their headaches can be easily managed and treated.
How you can help your doctor make the right diagnosis?
You should understand there is no particular test to precisely diagnose migraine headaches. so make a firm diagnosis, the doctor will ask for detailed history of the child’s headache that include:
The frequency of headaches, their severity, and symptoms that go with them
Any family history for these types of headaches
The effects of these headaches on child’s daily activities
The doctor will thoroughly examine your child through physical examination and will also complete a neurological assessment.
MRI or CAT scans, where images of the brain cannot help in migraine diagnosis, although in some cases they can be used to diagnose other causes of headaches.
Keeping a migraine diary
For proper diagnosis, it’s important to maintain record of the details of the migraine attacks. More information will definitely help your doctor. You can get migraine diaries from many online sources. Do not forget to include any warning signs or triggers noticed or felt by you or your child right before the attack. Recording the time when attack starts and finishes gives vital information to the doctor about the recurrent natural of your child’s condition.
You child should describe the features of the headache and how severe their head pain is. You can even come with your own scale to judge the exact level of pain being experienced by your child. Also maintain a record of medication taken during each migraine attack.
The record of headache should be kept even after a diagnosis has been made. This information can be used to examine the effectiveness of ways being used to manage and treat the headaches. These records will also shed some light on effects of different aspects of child’s lifestyle on their migraine, and it will be easy for you to identify triggers.
Assessing the effect of migraine
In children, the effects of migraine can be assessed by noting the number of days they miss their school, any extra hours they spend sleeping or resting during episodes, and the number of sporting and social activities they miss during the episodes.
Many doctors use Migraine Disability Assessment Scale (MIDAS), which involves asking your child a series of specially designed and tested questions. The answers to these questions help them work out number of days of disability caused by their migraine in a three month period. The suffering child then gets one of the four different MIDAS grades that can be easily used and interpreted by the doctor.
Migraine management principles
After a through diagnosis of child’s headaches and assessment of the level of disability, efficient management of the condition can potentially lessen its impact. Taking steps to manage migraine attacks in childhood will definitely help the condition to improve in later life. It’s important to implement “migraine-friendly” routines when child is quite young and may help prevent the condition from manifesting as they grow older.
At this stage it is important you and your child understand the significance of sticking to the routine for managing migraines. For instance, aiming to reduce the frequency of headaches may be a realistic idea, but wishing for a life free of headaches may not be. A goal that is realistic will prompt your child to adhere to a routine to attain success. They may feel much better and have a sense of achievement once their condition has been brought under the control.
Many migraine sufferers may use some ways to relieve physical tension to avoid attacks. For instance, physical therapy and massage are used to reduce muscle pain in the shoulder and the neck. A common cause of this pain in child is a heavy school bag.
Significance of Acute Treatment
Medicines taken to relieve the disability and pain of a migraine attack and stop it from developing is termed as “acute treatment”. In many children, timely treatment can reduce disability period and ensure recovery within an hour.
In due course, your child will be able to tell you the approximate time when they’re going to get a headache. in this situation, if you start the treatment early, it is possible to stop attack from developing further.
It’s important to immediately handle the attack early before the migraine pain becomes more severe. The earlier the medication is taken , the more likely it’s capable to stop many features of a migraine. You can first try non-prescription medicines such as ibuprofen or paracetamol. These medicines should be given in right doses as per the information sheets that accompanies the medicine, or from a pharmacist or a doctor. If non-prescription medicines fail to help, it’s best to discuss this with a doctor on other available options (rather than increasing the dose, and risk medication over-use headaches).
Most of the times, these treatments are sufficient to stop a migraine attacks from developing. If the migraine attack continues, despite the treatment, the best option is to put child in the bed and encourage them to somehow sleep, or at least take rest. You can give another dose of pain-killing drug when its due. When they’ll wake up from sleep, maybe a short one, many will have fully recovered.
Specific anti-migraine drugs
Sometimes child may get severe headache, even after getting acute treatment steps. Or it may be because their headache does not respond to the medicines or steps. In such cases, a doctor may go ahead and prescribe an anti-migraine drug. The doctor will also advise on the best time to take them.
Some adults with severe migraines are treated with triptans (a special class of migraine drugs). Some trials have show that children can also take them. The can be taken as pills, as a nasal spray, as quick dissolving tablets, or as an injection. On average, all those who take triptans by mouth may get quick relief within 25-30 minutes. A doctor will be able to discuss about your child’s specific needs, and the most effective way for them to take their medication.
One triptan (sumatriptan, Imigrain ) nasal spray at 10 mg has been specifically licensed in the United Kingdom on prescription for kids aged between 12 and 17. It is to be sprayed into one nostril.
Ideally, it’s important to match the individual features of your child’s headache to find a suitable plan to manage them at an early stage. Try to record the details of the attack throughout the treatment programme to help the doctor in assessing the medication affects.
Sometimes acute medication fails to provide the desired relief from an attack. In these times, your child’s doctor may prescribe a different medication to use. This “rescue medication” can be used if your child’s acute treatment fails to work. An anti-emetic (anti-nausea) medication to stop any sickness, plus pain-relieving or anti-inflammatory medication may be prescribed. Write down the instances when you used rescue medication on your child’s diary.
Preventative medication and children
Some kids may continue to experience disabling headaches even after taking acute treatments and changing their regular lifestyle. In this case, it’s best to discuss this matter with doctor and seek advice if use of preventive medication (that tries to stop the headache happening).
Doctor will prescribe mediation not just on the basis of frequency of headaches. This decision will depend on the effect of headaches on your child’s life. If these headaches are affecting badly, a doctor can prescribe different types of preventive medications. Little evidence is available on children with migraines. Research involving only adult migraine patients is used while deciding on which drugs to prescribe. Doctors may also base their decisions on prescribing treatment on their past experience.
Migraine preventatives have now been developed to properly treat many other conditions. Experience shows that these drugs can effectively stop migraine attacks from happening. For this reason, your child may be prescribed:
an anti-depressant such as amitriptyline;
an anti-convulsant, such as topiramate or divaloproex sodium;
a beta-blocker, such as propranolol;
an anti-histamine, such as cyproheptadine;
an anti-inflammatory drug, such as pizotifen.
You can also use other drugs that are not listed here, based on the experience of your child’s doctor. Your doctor will also discuss with you how long your child should take this preventive medication. Mostly, migraine prevention medication is taken by kids for three to 18 months. This treatment can certainly lead to lesser number of headache days experienced by the child. This improvement mostly carries on when a child stops taking the preventative drug.
It’s wise to choose carefully the exact time when your child should stop taking these preventative medication, for instance at the start of any long school holiday. This will certainly reduce any kind of disruption. You should also record any attacks that happen when your child is taking this preventative medication. You should keep a close watch and record what is happening, to help doctor in deciding whether this medication is helping in reducing the headaches.
Concerns about effects of medication on children
Drugs action on the body can be complicated, and in many places, not just the parts we want them to. This can lead to many side effects, besides planned benefits. When prescribing any medication for the child, a doctor will talk to the parents about the possible side effects. These are mostly listed on the information sheet that accompanies with the medication. So you need to write down all changes you or your child sees that you think might be a side effect of the medication. It’s important to discuss all these changes with a doctor. Some of these side effects will go with time, but a doctor may want to reduce the dose or may even change the medication.
The dangers of over-using migraine medication
“Medication overuse headache” is quite common with people over-using painkillers, such as paracetamol. Many medications contain combination of drugs with caffeine or codeine that have long been suspected to cause medication overuse headache. For this reason, instead of managing your migraine, use of these drugs on regular basis or more than four days a week can actually make your headaches worse. It is very important to avoid over-using medication. You should seek medical advice if your child has begun using painkillers or more than four days in a week.
When is the time to worry about a headache
In most cases, kids will experience “primary” headaches, where headache is itself a condition. Sometimes the headache can be secondary where pain may be due to some serious condition.
There are few important warnings that may suggest a child’s headache is secondary:
Continuous head pain that gets worse indicating a more serious cause
Any headache symptoms in early morning should be immediately discussed with a doctor
Any headache that happens without accompanying migraine symptoms can be a cause of concern
Changes in a child’s vision, excessive vomiting, weakness or lack of co-ordination, balance issues should also be discussed with a doctor
If headache symptoms change, it’s important to discuss changes with your doctor
Any change in behavior with a headache can be a warning sign. Some examples include a sudden personality change, or a drop in a school performance
The role of your child and of supervising adults
A child suffering from migraine should play an active role in managing their condition. The more your child understands about the experiences with migraine, the less worry this condition is likely to cause. If child is recording triggers and attacks, they should take steps to understand more about the steps they can take to manage their condition. The ultimate aim is to make your child comfortable more in control, rather than feeling the migraine is controlling them.
Managing migraine at school and away from home
Many children get headaches when they are away from their home. The supervising adult should have sufficient information to deal with the migraine attack. When a child gets a attack, parents are often contacted and requested to take their child home. In some cases, if help is given without wasting time, the child can even recover and can continue their activities.
If your child is at school, try to speak to the head teacher and discuss the child’s condition. Every school has a policy on supporting kids with medical needs. Sometimes it’s important to make a special appointment at school, the supervisor and your child to discuss about the headaches. this is purely a voluntary role, but most of the time staff are supportive and happy to take on this duty. School nurses and teachers, or others who regularly supervise children, can change the effects migraines have on a child.
Migraine treatment sheet
Being very individual, children with migraine may need a different plan to properly manage their condition. Begin by giving as much information as you can to the school on avoiding the attack and recognizing when your child is going to have an attack. Try to give staff the advice on steps to take if your child does have an attack. For instance, you may want to give them a dose of painkiller which the can give to the child if a migraine attack develops while they’re away from home.
Managing migraine at school
In many cases, two simple treatment steps can help to stop a migraine attack from developing. It’s very important to encourage your child to eat. If they’re not so hungry, or they feel sick at the mere sight of the food, they may be able to have some drink with added sugar (such as juice, sports drink, or soft drink), or a simple glucose tablet.
It’s very important for the child to take all medications prescribed by their doctor. So keep their dose ready and give them when necessary. In some cases, you may have to supervise the child while they take their dose. A child may also need to take anti-sickness drug, as well as medication for their headache.
In many cases, the recovery of child is fast and will be in a position to join class. If migraine attack continues, it’s best to let the child rest and encourage them to sleep. Some kids recovery fully once the wake up from a sleep, however short the nap is. Some kids may not respond to common painkillers. When headaches have big effect on a child’s life, their doctors may advise a specific anti-migraine treatment.
Migraine medications show effects within 25-30 minutes. The parents and child will be able to tell you as to what happens with an attack once treatment has been given. They will also be able to tell you about side effects, and the action they need to take if the child experiences any of these effects.
Make sure the classroom is also well ventilated as this can help some children avoid attacks at school. Suggesting ways to study which reduces stress will also help a child. When child is recovering from an attack, they will find it cumbersome to do their homework. Giving whole hearted support to the child to catch up on any missed work will definitely help them break the pattern of attacks.
You should try to speak to them about when they feel most sensitive to migraine attacks, for instance, during exams. The ability of young kids to revise for, and then appear in exams, may be severely affected by their condition and their results may also vary.
Even though a child with migraine needs special attention, it’s very important they feel absolutely normal as possible. It’s important to grade child according to their individual ability, and should never be downgraded on the basis of their condition.
Supporting young migraine sufferer can sometimes put strain on the entire family and may mean cancellation of events at the short notice. This can leave the child, and your entire family feeling frustrated. At this point, it’s important to sit and talk together about these feelings so that child doesn’t feel different due to their condition.
Answering your questions
I’m sure you’ll find this information useful. However, it’s not a substitute for the advice of a pharmacist or a doctor.
Migraine can crease issues for you and your child that will be common to other conditions. For instance, you child may want to avoid going to school because they are scared of having an attack right in front of friends. This is also true for kids with epilepsy. It’s important to discuss this with your child. Do everything possible to instill confidence in your child that it’s easy to cope with the issue and get along with day-to-day life.