Condition Basics

What are migraine headaches?

Migraines are a common type of headache in children. They are an intense, throbbing headache that can be felt on one side or both sides of the head. They can sometimes be hard to tell apart from other types of headaches. Different things can trigger migraines in different people.

What causes them?

Experts aren't sure what causes migraines in children. They believe that changes in the activity of brain cells may lead to inflammation in certain nerves, which causes pain. Migraines often run in families, so genetics may play a role for some children.

What are the symptoms?

Migraine headaches may cause a painful throbbing that can be felt on one or both sides of the head. Your child may have other symptoms such as nausea, vomiting, sensitivity to light or noise, and changes in vision, such as flashing lights or dark spots.

How are they diagnosed?

Your child's doctor will do a physical exam and ask questions, such as how often the headaches occur and what the symptoms are. The doctor will also ask about your child's overall health. Other exams and tests are usually recommended only if the doctor finds signs of other health problems.

How are migraine headaches treated?

Migraine headaches can be treated with over-the-counter pain relievers, such as children's acetaminophen or ibuprofen. If this doesn't help, or if the headaches happen often, your doctor may prescribe other medicines. Home treatment, such as resting and managing stress, can also help your child feel better.

Prevention

To prevent migraine headaches in your child, try these tips.

• Keep a headache diary.

  This can help you figure out what triggers your child's headaches. Record when each headache begins, how long it lasts, where it hurts, and what the pain is like. Write down any other symptoms your child has with the headache, such as nausea, flashing lights or dark spots, or sensitivity to bright light or loud noise. List anything that might have triggered the headache. When you know what things trigger your child's headaches, try to avoid them.

• Make sure that your child drinks plenty of fluids.

  Avoid drinks that have caffeine. Many popular soda drinks contain caffeine.

• Make sure that your child gets plenty of sleep.

  Most children need to sleep 8 to 10 hours each night.

• Encourage your child to get plenty of exercise.

  But make sure your child doesn't exercise too hard. For some children, strenuous exercise may trigger a headache.

• Encourage your child not to skip meals.

  Provide regular, healthy meals.

• Keep your child away from smoke.

  Do not smoke or let anyone else smoke around your child or in your house.

• Find healthy ways to deal with stress.

  Do not overbook your child's time.

• Seek help if you think your child may be depressed or anxious.

  Treating these problems may reduce the number of migraines your child has.

• Limit the amount of time your child spends in front of the TV and computer.

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Symptoms

Symptoms of migraine headaches may include:

• Throbbing on one or both sides of the head. The pain may move from one side of the head to the other.
• Nausea, vomiting, or both.
• Sensitivity to light, noise, and sometimes smells.
• Changes in mood.
• Changes in vision, such as seeing flashing lights or dark spots, before the headache starts. This symptom, called aura, is more common in adults than in children.
• Feeling light-headed or dizzy.

Migraines can make it hard for your child to do daily activities.

Some children, especially younger ones, may not say when they feel a headache. So watch for other signs. Your child may:

• Act cranky or upset.
• Fall asleep at an unusual time or act sleepy.
• Be less active than usual or not watch TV.
• Rub his or her eyes or head.
• Avoid noise or bright light.

Without treatment, your child's migraine can last as long as 72 hours.

What Happens

Migraines in children sometimes start with an aura of spots, wavy lines, or flashing lights about 30 minutes before the headache begins. Without treatment, a migraine headache can last from 2 to 72 hours. Having a stiff neck or feeling very tired may last for up to a day after the migraine ends.

When to Call a Doctor

Call 911 or other emergency services anytime you think your child may need emergency care. For example, call if:

• Your child has a very painful, sudden headache that's different than any your child has had before.
• Your child has a fever and a stiff neck.
• Your child has a headache with sudden weakness, numbness, trouble moving parts of the body, vision problems, slurred speech, confusion, or behaviour changes.

Call the doctor or seek medical care now if:

• Your child has headaches after a recent fall or a blow to the head.
• Your child has new nausea or vomiting, or they cannot keep down food or fluids.

Watch closely for changes in your child's health. Call the doctor if:

• Your child wakes up in the morning with a headache and vomiting, and this happens more than a few times.
• Light hurts your child's eyes.

• Your child has a headache that does not get better within 1 or 2 days.

  Your child's headaches get worse or happen more often.

• Your child's headaches cause your child to take pain medicines often.
• Your child is often missing school, sports, or other activities because of their headaches.

Exams and Tests

Your child's doctor will do a physical exam and ask questions, such as how often the headaches occur and what the symptoms are. The doctor will ask about your child's overall health.

Migraines can be similar to other kinds of headaches, which may have different treatments. So it's important for your child's doctor to find out what kind of headache your child has. The doctor can rule out other health problems that may be related to the headaches.

It's common for parents to feel concerned about their child's headaches. You may feel that more testing is needed to rule out serious causes. But doctors often can find out the type and the cause of the headaches without using other tests.

In some cases, imaging and other tests may be recommended to rule out other health problems. But this isn't common. These tests include:

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Treatment Overview

Migraine headaches can be treated with over-the-counter pain relievers. This includes children's acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). If this doesn't help, or if the headaches happen often, your doctor may prescribe other medicines. Home treatment, such as resting and managing stress, can also help your child feel better.

If over-the-counter medicines don't help, doctors may prescribe medicines called triptans, such as sumatriptan. Your doctor also may prescribe medicines to help with nausea.

Have your child take any medicines at the first sign of a migraine. This helps stop the headache before it gets worse.

If your child's migraines are severe or happen often, your doctor may prescribe a daily medicine to help prevent them. This medicine may also be prescribed if headaches interfere with school or other activities. Have your child take that medicine every day, even if your child does not have a headache.

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Self-Care

Here are some steps you can take to treat your child's migraines at home.

• Begin home treatment at the first sign of a migraine. Your child should go to a quiet, dark place and relax. Most headaches will go away after rest or sleep.
• Let your child know that watching TV or reading during a headache can make the headache worse.
• If your doctor has prescribed medicine to stop your child's migraines, have your child take it at the first sign of a migraine. This can help stop the headache before it gets worse. If your doctor has prescribed medicine to be taken daily, make sure that your child takes it every day even if your child does not have a headache.
• If your doctor has not prescribed medicine for your child's migraines, give your child a pain reliever, such as children's acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). Have your child take the medicine at the first sign of a migraine. This can help stop the headache before it gets worse. Be safe with medicines. Read and follow all instructions on the label.
• Don't let your child take medicine for headache pain too often. Talk to your child's doctor if your child is taking medicine more than 2 days a week to stop a headache. Taking too much pain medicine can lead to more headaches. These are called medicine-overuse headaches.
• Put a cold, moist cloth or ice pack on the part of the head that hurts. Put a thin cloth between the ice and your child's skin. Do not use heat—it can make the pain worse.
• Gently massage your child's neck and shoulders.
• Do not ignore new symptoms that occur with a headache, such as a fever, weakness or numbness, vision changes, or confusion. These may be signs of a more serious problem.

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