People of all ages experience migraine and the symptoms in children are similar to those in adults. They can include moderate to severe headache, nausea, vomiting and sensitivity to light and sound.
The underlying mechanisms of migraine in children are unclear, but genetics may play a role. In addition, about half of children who experience migraine stop showing symptoms after puberty.
In this article, we describe the symptoms, causes and treatments of migraine in children.
About 3 to 10% of children have migraine. The prevalence increases with age until puberty, when about half of these children or adolescents stop having migraine episodes.
Alternatively, if migraine symptoms begin during adolescence, it is more likely that the person will continue to experience the disease into adulthood.
Before puberty, migraines are as likely to affect men as women. After puberty, women are more likely to experience it.
Children with migraine exhibit many of the same symptoms as adults. This may include:
- a headache that lasts 2–72 hours
- a headache on one side of the head
- moderate to severe pain
- pain that worsens with physical activity
- sensitivity to light or sound
- nausea or vomiting
- aura, sensory disturbances, such as lights flashing in the field of view that may be the first symptom
According to the National Migraine Center in the UK, children are more likely to experience pain in several places or across the head, compared to adults.
In addition, episodes in children may be shorter than in adults.
It can be difficult to diagnose migraine in young children, who may be unable to describe their symptoms. Another challenge involves subjectivity in the intensity of pain – children and their parents or caregivers may have little or nothing to compare. For these reasons, doctors rarely diagnose migraine in children under 2 years old.
Finally, it is important to note that, for some people with migraine, the headache is absent or is a minor symptom.
Researchers do not know why some children suffer from migraine and others do not. However, many children with migraine have relatives with the disease, suggesting that there is a genetic component.
Experts know that certain genetic mutations predispose children to some types of migraine. For example, if a child has hemiplegic migraine, a type that causes temporary weakness and paralysis, he may have a mutation in any of the following genes:
Research into the causes of other types of migraine is ongoing.
People with migraines often find that certain foods, situations or environmental factors trigger migraine episodes. Identifying these triggers can often help prevent episodes.
However, identifying the triggers can take some time. It is also important to note that several triggers often overlap to contribute to the development of a migraine episode.
It can help to keep a record of your child’s migraine symptoms and any possible causes. We provide specific ideas on what to note in the “Home care” section below.
Common triggers to consider include:
- Changes in sleep patterns: A child can have an episode if they sleep too much or too little. It can help to establish and maintain a regular sleep schedule.
- Dehydration: Ensuring that your child drinks enough water, especially after physical activity, can help reduce migraine symptoms.
- Food and drinks: Specific foods can trigger symptoms and therefore eat little. Observe what a child has eaten on days when he has symptoms and check for a pattern.
- Stress: Stress and over-stimulation can contribute to migraine. If a child frequently feels stressed and anxious, he or she can benefit from a quiet space in which to calm down. Mindfulness activities for children can also help.
- Environmental triggers: This can include climate change, secondhand smoke and bright lights, including those on computer or phone screens, for example.
Not all migraine triggers are preventable, but avoiding them whenever possible can reduce the frequency of episodes.
If a child is experiencing symptoms of migraine, a doctor may recommend an appropriate dosage of an over-the-counter (OTC) drug, such as:
However, these drugs and dosages are not always suitable for children. Check with a doctor or pharmacist before administering any OTC medication to a child.
If a child has severe or frequent migraine episodes, the doctor may also prescribe a medication from a family of medications called triptans. They work specifically to prevent migraine episodes.
The Food and Drug Administration (FDA) has approved sumatriptan (Imitrex) and rizatriptan (Maxalt) for use in children.
If a child does not respond well to triptans, the doctor may prescribe:
- beta blockers
- amitriptyline (Elavil) or nortriptyline (Pamelor)
- antiepileptic drugs
Some children may also respond to relaxation or biofeedback training.
In addition to administering medications and helping to prevent exposure to triggers, caregivers and children can use other strategies to help control migraine symptoms:
During an episode
When migraine symptoms occur, try:
- move the child to a quiet, dark room
- applying cold or hot compresses to the head
- offering them an eye mask to block any light, if they are sensitive to light
- massaging any tight or sore muscles
- encouraging the child to sleep, if it helps with his symptoms
Anyone keeping a symptom diary should take note of:
- the time and date when the symptoms occurred
- the duration and severity of the episode
- if any treatment or strategy helped
- any possible triggers
Preparation
Being prepared for migraine episodes can help limit its effects. A person can:
- Make one or more migraine kits, including items such as medication, hot or cold compresses, an eye mask, water, and a symptom diary.
- Learn about potential triggers and identify specific ones.
- Help to identify any warning signs that symptoms are appearing.
- Inform schools, daycare centers and other caregivers about the child’s experiences and what to do if a migraine episode occurs.
It is important to keep in mind that administering painkillers as soon as possible can help to stop the progression of the migraine episode.
Emotional support
It can be difficult to assess the extent of migraine symptoms in a child. Depending on their age, they may not understand their condition or be afraid of it.
During an episode, it is important to be calm and calm. After that, it may be useful to teach your child about the disease or ask a doctor to explain it to them.
Understanding what migraine is and that each episode ends eventually can alleviate some fears. It can also be helpful for the child to take a proactive role in managing the disease, for example, maintaining or helping with a symptom diary.
Contact a doctor about a child’s migraine symptoms. They can prescribe medication to reduce the severity and frequency of episodes. It is also important that they exclude other possible causes of the symptoms.
Some symptoms of migraine are similar to those of more serious health problems. Seek emergency medical attention if a child has:
- a sudden and severe headache with no other migraine symptoms
- a headache with the worst pain they have ever experienced
- a headache after a head injury
- a headache and any of the following:
- a stiff neck
- confusion
- a seizure
- loss of consciousness
Talk to a doctor immediately if a child has migraine symptoms next to:
- changes in vision, balance or coordination
- excessive vomiting
- persistent pain
- a recent change in personality or behavior
Any of the above options can indicate a different underlying condition.
In children, migraine is not uncommon and symptoms can occur from an early age. Taking OTC pain relievers as soon as symptoms develop can stop or limit their effects. Instead, the doctor may prescribe medications targeted for migraine.
It is important to receive medical attention for any migraine symptoms. The doctor needs to be sure of the cause because some symptoms resemble other health problems.
In addition to prescribing medications, the doctor can provide guidance on how to identify triggers and control episodes.