Migraine in Children

Migraine in Children: Causes and Treatment

Migraine is a prevalent primary headache disorder that affects a significant portion of the pediatric population, ranging from children to adolescents. While migraine is a well-recognized disease in adults, diagnosing it in children presents a unique set of challenges, leading to frequent misdiagnosis or underdiagnosis.

Prevalence and Recognition:

Studies indicate that the prevalence of migraine in children and adolescents varies widely, ranging from 5% to 40% in the pediatric population. (Source) Despite its common occurrence, migraine is frequently overlooked in children. This is due to several factors, including the difficulty in expressing symptoms accurately and the overlap of symptoms with other childhood illnesses. This underlines the importance of recognizing and addressing migraine in the early stages to mitigate its impact on a child’s quality of life.

Impact on Quality of Life:

Migraine not only affects the physical well-being of children but also has a considerable impact on their academic performance, social interactions, and overall quality of life. Undiagnosed or misdiagnosed migraine can contribute to increased school absenteeism, decreased participation in extracurricular activities, and a heightened risk of anxiety and depression in affected children. Early intervention can help improve the child’s quality of life and prevent potential complications associated with untreated migraine.

What Causes Migraine in Children?

The exact cause of migraine in children is not fully understood. It likely involves a combination of genetic, environmental, and neurobiological factors. Migraine is considered a primary headache disorder, meaning it is not typically a symptom of an underlying medical condition but rather a distinct neurological condition. 

Most children with a history of migraine seem to have a positive family history, and some studies have shown genetic contributions. Children with a parental history of migraine develop the condition an average of 11 to 12 years earlier than their affected parents. Source.

Migraine attacks in children can be triggered by various factors. Common migraine triggers include certain foods, inadequate sleep, changes in routine, stress, hormonal fluctuations (especially in adolescents), and environmental factors like strong odors or bright lights.

Migraine Symptoms in Kids

Migraine symptoms in children can vary widely. They may not always manifest in the same way as they do in adults. Recognizing these symptoms is crucial for early diagnosis and effective management.

Headache:

Children with migraine often experience moderate to severe headaches. The pain is typically pulsating or throbbing and can occur on one or both sides of the head. The head pain may be aggravated by physical activity and may lead to avoidance of play or sports.

Abdominal Pain:

Some children with migraine may complain of abdominal pain or discomfort. This can include nausea and vomiting, which are common migraine-associated symptoms in children.

Aura:

While auras are more commonly associated with adult migraine, some children also experience visual disturbances before or during a migraine episode. Auras may include flashing lights, zigzag lines, or temporary vision loss.

Sensitivity to Light and Sound:

Children with migraine often become sensitive to light (photophobia) and sound (phonophobia) during an attack. They may seek a dark and quiet environment to alleviate discomfort.

Dizziness and Vertigo:

Migraine in children may be accompanied by feelings of dizziness or vertigo. This can contribute to instability and difficulties with balance.

Mood Changes:

Migraine can influence a child’s mood, leading to irritability, mood swings, or feelings of sadness. Behavioral changes may be notable during a migraine attack.

Difficulty Concentrating:

Children living with migraine may find it challenging to concentrate on tasks or schoolwork. This can impact their academic performance and attentiveness in the classroom.

Physical Symptoms:

Migraine in children can manifest with various physical symptoms, such as fatigue, pale complexion, and sweating. These symptoms may occur alongside the head pain or as part of the prodrome or postdrome phases.

Duration and Frequency:

Migraine attacks in children can last anywhere from a few hours to a couple of days. The frequency of attacks varies from child to child. Some experience migraine attacks infrequently, while others may have them more regularly.

It’s essential for parents, teachers, and healthcare providers to be aware of these symptoms, especially considering the challenges children may face in articulating their discomfort. If a child exhibits recurrent or severe symptoms suggestive of migraine, consulting with a healthcare professional for a comprehensive evaluation is crucial for accurate diagnosis and appropriate management. 

Challenges in Diagnosis:

The diagnosis of pediatric migraine is complicated by the diverse and sometimes atypical nature of symptoms. Unlike adults, children may not always experience the classic throbbing headache and may exhibit symptoms such as abdominal pain, dizziness, or even behavioral changes. Additionally, children may struggle to articulate their symptoms effectively, making it challenging for healthcare providers to obtain a clear clinical history.

Misdiagnosis and Its Consequences:

The challenges in diagnosing pediatric migraine often result in misclassification or misdiagnosis. This includes the varied presentation of symptoms and difficulties in communication, contributing to frequent misdiagnosis. Migraine symptoms can be mistakenly attributed to other common childhood ailments, such as tension-type headaches, sinusitis, or gastrointestinal issues. The consequences of misdiagnosis can be significant, leading to delayed treatment, unnecessary medical tests, and a prolonged period of discomfort for the child.

How to Treat Migraine in Children

The treatment of headache disorders and migraine in children involves a combination of lifestyle modifications, behavioral strategies, and, in some cases, medications. Research shows different options for possible treatment for kids with migraine. It’s important to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan. Various approaches on how to manage migraine apply to children.  Tailoring the approach to the individual child’s needs and addressing triggers can contribute to a more effective management plan for headache disorders and migraine in children.

What Can You Do for a Child With Migraine?

Addressing migraine in children involves a multi-faceted approach, encompassing early diagnosis, psychological support, and mindfulness techniques.

Early Diagnosis:

Recognition of Symptoms: 

Be attentive to the child’s behavior and complaints. If they consistently exhibit symptoms like headache, nausea, vomiting, sensitivity to light or sound, or mood changes, consult with a healthcare professional for a proper diagnosis. Recognizing the unique aspects of pediatric migraine is crucial for timely intervention and improved outcomes. Emphasizing the importance of raising awareness among healthcare providers, parents, and educators alike will help in the process.

Keep a Headache Diary:

Maintain a headache diary to track the frequency, duration, and potential triggers of the child’s attacks. This information can assist healthcare providers in making an accurate diagnosis.

Seek Psychological Help:

Consult with a Pediatrician, Neurologist, or Headache Specialist:

Start by consulting with a pediatrician, neurologist, or headache specialist who specializes in pediatric headache disorders. They can conduct a thorough evaluation, including medical history and, if necessary, imaging studies to rule out other potential causes.

Psychological Evaluation:

If stress, anxiety, or other psychological factors are suspected triggers, consider involving a child psychologist or counselor. This may help the child cope with stressors and develop effective coping mechanisms.

Mindfulness and Relaxation Techniques:

Deep Breathing Exercises:

Teach the child deep breathing exercises to promote relaxation. Encourage slow, deep breaths in through the nose and out through the mouth during a migraine attack.

Mindfulness Meditation:

Mindfulness meditation techniques may help the child stay present and reduce anxiety.

Create a Migraine-Friendly Environment:

Dim Lights and Quiet Space:

During a migraine attack, create a calm and quiet environment. Dim the lights or draw the curtains to reduce sensitivity to light. Provide a comfortable, quiet space for the child to rest.

Temperature Control:

Ensure the room is at a comfortable temperature, as extreme heat or cold may exacerbate migraine symptoms.

Hydration:

Offer water to keep the child hydrated, as dehydration can contribute to headaches.

Educate and Empower:

Educate the Child: Help the child understand their condition by explaining what migraine is and providing age-appropriate information. This can empower the child to recognize triggers and actively participate in their care.

Communication:

Encourage open communication between the child, parents, and teachers to create a supportive environment. Migraine at School is a good place to start.

Connection:

Participate in Run Walk events to raise awareness and funds to help children and adults living with migraine and headache disorders.

Remember, each child’s experience with migraine is unique. The approach to managing migraine may need to be tailored to their individual needs. Consistent support, understanding, and a collaborative effort between parents, healthcare professionals, and educators can significantly contribute to effective management and improved quality of life for children with migraine.

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