Migraine Headache

What is migraine?

A migraine is a specific type of headache which happens from time to time.

How does it occur?

The specific causes of migraine headaches are not well understood. Migraine headaches tend to run in families, and often are triggered by specific factors. Triggers of migraine headaches for some children include stress, missing a meal, a change in sleep pattern, bright or flickering lights, loud noises, and specific foods (chocolate and nuts are sometimes causes).

What are the symptoms?

Often your child will feel the headache coming on and have a sensation of flashing lights, a feeling of tingling or numbness in a certain area, hear a buzzing or humming sound, or have other sensations. This is called an "aura."

Symptoms of migraine headaches may include:

• headache which is often on one side of the head only and often described as "throbbing" or "pulsing"
• abdominal pain, nausea, or vomiting
• pale skin color
• a desire to avoid bright lights and loud noises.

How is it diagnosed?

Your child's health care provider will ask about the symptoms. Migraines often get better with sleep, which may be a helpful clue in the diagnosis. Children, especially younger children, often have difficulty explaining their symptoms. Your health care provider may ask you to keep a log of when your child's headaches happen and anything thing that happened before the headache (such as eating certain foods or not getting enough sleep).

How is it treated?

An important part of treatment for migraines is avoiding the triggers for the headaches. Medicines such as acetaminophen or ibuprofen can help milder migraines. Other pain medicines may be prescribed by your health care provider if the headaches are more severe or frequent. Medicines which keep your child from vomiting are also sometimes used.

How can I take care of my child?

When your child is having a migraine, put him or her in a quiet, dimly lit place where they can rest. Take note of the possible triggers of your child's headaches and help your child avoid these items or situations in the future. Regular exercise and keeping routine times for eating and sleeping may keep your child from having a lot of migraines.

How long will it last?

A migraine headache can last anywhere from 2 to 48 hours. Children with migraines often have 1 to 3 headaches each month, though this can vary from as few as one every few years to several times a week. After the headache goes away, some children may still feel tired or irritable, though others have no problems.

More than half of children with migraine headaches beginning before age 10 will have improvement after age 10. Many children do not have as many migraine attacks as they get older, even if their migraines began after age 10.

When should I call my child's health care provider?

Call immediately if your child has:

• severe pain which is not typical of their migraine headaches
• is not responsive or acts confused
• a seizure occurring with a migraine.

Call during office hours if your child has:

• a change in the character of his or her headaches, particularly a headache that awakens your child from sleep or occurs in the early morning
• behavioral changes or worsening school performance despite treatment of your child's headaches.