Headache & Migraine

HEADACHE AND MIGRAINE IN KIDS

Migraine headaches (migraines) are a type of severe headache that usually affects one side of the brain. Some children get migraines every now and then, while others get them more than once a week.

Migraines tend to run in the family and about half of children who get migraines will continue to have them when they are adults.

Migraines are more common in females in adolescents and adults, while they occur equally in boys and girls in children. Migraines, although painful and annoying at times, are not typically a significant condition, and they are not life-threatening. Controlling your child’s symptoms and avoiding future migraines are the goals of treatment.

Types of migraine in children (IHC CLASSIFICATION)

Including variants (some rare) seen in childhood:

  • Migraine without aura – the most common variety in children and adults.
  • Migraine with aura – 14-30% of migraine in children and including:
    • Aura without headache – more common in childhood.
    • Hemiplegic migraine – more common in childhood.
    • Basilar migraine – more common in childhood, particularly in young girls.
    • Ophthalmoplegic migraine – very rare but more common in children than in infants, and even rarer in adults.
    • Acute confusional migraine – seen in childhood.

Childhood periodic syndromes – commonly precursors of migraine and include:

  • Cyclical vomiting.
  • Abdominal migraine.
  • Benign paroxysmal vertigo of childhood.

Retinal migraine – seen more in children and in young adults.

Probable migraine.

 

What are the causes and trigger factors of migraine in children?

A migraine attack may be brought on by:

  • stress
  • irregular sleep
  • traumatic brain injuries
  • certain foods
  • weather changes
  • hormonal changes

What are the signs and symptoms of Migraine ?

Toddlers and small children may have headaches, nausea/vomiting, and a sudden paleness.

Migraines in older children and teens are more adult-like. The most frequent symptom is a headache that lasts six to twelve hours and may be:

  • severe
  • either dull or throbbing
  • all over your head, or much worse, on the sides of your skull
  • on a single side of the head
  • lose their appetite, have nausea (feel sick) or vomit
  • tiredness
  • stomach pain.

When should you visit your doctor?

It may be evident, especially if you suffer from migraine, that your child’s symptoms are characteristic of migraine. If the attacks have clear causes, symptoms respond to pain relievers, and your child is generally well, it is unlikely that you need to consult a doctor. However, if you have any doubts regarding the nature or origin of your child’s headaches, if your child seems generally ill, or if the headaches are interfering with everyday activities, you should schedule an appointment for your child to visit a doctor.

It is especially important to contact a doctor if any of the following conditions exist:

  • Headaches start under age 7
  • An unaccountable increase in frequency, severity and duration of attacks
  • Personality/behavioral changes
  • Balance or coordination problems
  • Failure to grow/attain normal developmental goals

What are the diagnostic methods for headache migraine in children?

  • Headache history. Your doctor will ask you and your kid to explain the headaches in detail in order to determine if there is a pattern or a consistent cause. Your doctor may also request that you maintain a headache journal for a period of time in order to record additional information regarding your child’s headaches, such as frequency, degree of pain, and potential causes.
  • Physical examination. A physical exam is performed by the doctor, which includes measuring your child’s height, weight, head circumference, blood pressure, and pulse, as well as evaluating your child’s eyes, neck, head, and spine.
  • Neurological exam. Your doctor examines you for any issues with movement, coordination, or sensation.
  • Magnetic resonance imaging (MRI).  MRI scans assist physicians in the diagnosis of cancers, strokes, aneurysms, neurological disorders, and other brain anomalies. A magnetic resonance imaging (MRI) scan may also be used to check the blood veins that nourish the brain.
  • Computerized tomography (CT) scan. A sequence of computer-directed X-rays are used in this imaging process to produce a cross-sectional image of your child’s brain. This aids physicians in the diagnosis of tumors, infections, and other medical issues that might cause headaches.
  • Spinal fusion (lumbar puncture). If your doctor feels that your child’s headaches are caused by an underlying disease, such as bacterial or viral meningitis, he or she may prescribe a spinal tap (lumbar puncture). A tiny needle is placed between two vertebrae in the lower back to retrieve a sample of cerebrospinal fluid for laboratory examination during this procedure.

 

What are the treatment options?

OTC pain relievers are medications. Acetaminophen or ibuprofen (Advil, Motrin IB, and others) may usually ease your child’s headaches. They should be taken at the first sign of a headache.

Medication. Triptans, which are prescription medications used to treat migraines, are effective and may be taken safely in children over the age of six.

If your child suffers from nausea and vomiting as a result of migraines, your doctor may prescribe an anti-nausea medication. However, the medication method varies from child to child. Consult your doctor for migraine treatment for your children.

Cognitive behavioral therapy(CBT). This treatment may assist your child in learning to cope with stress and minimize the frequency and intensity of headaches.