Guest Post by Dr. Merle Diamond –
Parents who suffer from migraines have more to worry about than how their headaches can affect their parenting. Adults who have migraines are more likely to have children who suffer from migraines, as well.
So, it’s something those parents probably have in the backs of their minds as they look for the warning signs that their children might be suffering from the same condition. Parents who don’t experience migraines themselves also may be concerned about whether or not their children’s headaches or other symptoms are signs of migraines.
Complicating matters is the fact that young children don’t have the capacity to explain what they’re feeling in a helpful way. Children suffering from intense migraine pain may not be able to tell their parents or pediatrician what they’re experiencing, which means parents may be powerless to help them. When it comes to migraine headaches, parents have to play detective in a way — identifying clues and evidence that can help them figure out what’s a simple headache or tummy ache and what’s a sign of a potentially more serious condition. Knowing what to look for makes it easier for parents to get their children the treatment they need faster.
For example, whether or not parents know the pain of migraines themselves, they should be on the lookout for signs of nasal congestion, swollen foreheads or eyes that are puffy. If these symptoms manifest in conjunction with a severe headache, they may be signs that a child is suffering from cluster headaches. Cluster headaches are severe episodes of pain that can recur over the course of weeks and even months. In other cases, migraines may not even feature headaches. Abdominal migraines are episodes of severe abdominal pain that can be accompanied by nausea and/or vomiting. What’s more, they may be an indication that a child will develop migraine headaches as he or she gets older.
The guide below details many of the most common varieties of migraines in children and their symptoms. If you’re concerned about helping your children feel better, this may be the best place to start.
Abdominal migraine affects mainly children between 5 and 9 years of age. Many of these children go on to develop migraine headaches (with or without aura) later in life.
What Are the Symptoms of Abdominal Migraine?
Symptoms may include:
- Midline abdominal pain of moderate to severe intensity that lasts 1 – 72 hours
- Chronic or recurring pain severe enough to interfere with normal activities
- Mild or no headache
- Nausea, vomiting, loss of appetite
- Pallor with dark shadows under the eyes or flushing
- The absence of another illness, including a gastrointestinal disorder
How Is Abdominal Migraine Diagnosed?
No specific diagnostic test is available to confirm abdominal migraine. A diagnosis is made through a thorough evaluation of the patient’s medical history, incidence of migraine headache in the family, symptoms, and a physical exam and tests to rule out other conditions.
What Are the Treatment Options for Abdominal Migraine?
For children and teens, abdominal migraine treatment includes rest, plenty of fluids, over-the-counter pain relievers and relaxation/behavioral therapy techniques. For older children and adults with infrequent abdominal migraine attacks, physicians may prescribe medications used for other forms of migraine, such as NSAIDs, anti-nausea medication and triptans. Frequent abdominal migraines are treated with the same preventive therapies used for other migraines.
The average age of onset for migraine is 7 years old for boys and 10 years old for girls, although symptoms may appear in much younger children. Up to age 12, equal numbers of boys and girls suffer from migraine; by the ages 21 – 24, up to 80% of migraineurs are woman. Children with migraine often have a family history of migraine. Migraine affects up to 5% of school-aged children. From 50% to 75% of children with migraine will cease having attacks between adolescence and early adulthood, but some will redevelop migraine later.
What Are the Symptoms of Migraine Headache?
Common symptoms of migraine in youngsters include:
- Pain on one or both sides of the head, or a child may report pain “all over”
- Pounding or throbbing pain, although children may not be able to articulate this
- Abdominal upset, nausea and/or vomiting
- Sensitivity to light and/or sound
- Becoming pale or quiet
- Experiencing an aura, or a sense of flashing lights, funny smells and changes in vision
This common headache type is triggered by stress or emotional/mental conflict.
What Are the Symptoms of Tension-Type Headache?
- Generally, symptoms include:
- Headache that develops slowly
- Pain usually present on both sides, and may involve the back of the head
- Dull pain or pain that feels like a band around the head
- Mild to moderate, not severe, pain
- Change in sleep habits
More common in adolescent males, cluster headache usually begins in children over 10 years of age. This headache type occurs in a series, or “cluster,” that can last for weeks or months. This series of headaches may recur annually or every other year.
What Are the Symptoms of Cluster Headache?
- Common symptoms in children and adolescents include:
- Unilateral (one-sided) pain, often behind an eye
- The affected eye may look droopy and have a small pupil, or the eyelid may be red and swollen.
- Congestion or runny nose
- Swollen forehead
Headache Associated With a Serious Issue
If your child shows these symptoms, consult a headache specialist to determine if there is a possible serious underlying cause:
- Headache in a very young child
- Headache pain that awakens a child
- Headaches that begin very early in the day
- Pain worsened by strain like a cough or sneeze
- Recurrent vomiting episodes or other signs of a stomach virus
- Child complaining about “the worst headache ever”
- Increasing severity of headache, or one that continues
- Personality changes
- Weakness in limbs or problems with balance
- Seizures or epilepsy
How Is Pediatric/Adolescent Headache Diagnosed?
An accurate diagnosis is the first step to effective treatment in children and adolescents with headache. A pediatric headache specialist should evaluate your child thoroughly, including a physical exam, inquiries into medical and family history, and diagnostic tests. The child may be asked to describe the pain, its location, the duration of the headache and more. The specialist may ask parents about changes in behavior, personality, sleeping patterns, emotional stress and if physical trauma preceded the headache. If symptoms indicate migraine or tension headache, specialists may not recommend further testing. But sometimes, additional diagnostic tests may be necessary; these may include blood tests, an MRI or CT scan, or a polysomnogram to check for a sleep disorder.
What Is the Recommended Pediatric/Adolescent Headache Treatment?
Each child receives an individualized treatment regimen that may include these components:
– Medication. Specific therapeutic agents are prescribed, and patient response is closely monitored to evaluate efficacy and minimize side effects.
– Lifestyle Modification. Patients are instructed in the areas of diet, recreation, sleep patterns and other habits linked to headaches.
– Biofeedback Training. This is a non-drug therapy that enables patients to actively participate in their treatment while alleviating headache symptoms. About 70% of all patients, and especially children, benefit from this training. Biofeedback augments other therapies and is particularly useful for patients for whom stress is a major contributing factor to headaches, or for those patients who are unable to use standard headache agents.
Whether you’re worried about your children inheriting your migraines or just concerned that their frequent moodiness might be something more serious, knowing the warning signs of migraines in children can be very useful for parents.
Author bio: Dr. Merle Diamond graduated with honors from the University of Michigan in Ann Arbor and received her medical education from Northwestern University Medical School in Chicago. She has been a part of Diamond Headache Clinic since 1989 and has contributed numerous articles to the medical literature, and has lectured extensively on various headache subjects.