Patient education: Migraines in children (The Basics)

What are migraines? — Migraines are a kind of headache that can also involve other symptoms. Migraines can affect both adults and children. They often start mild and then get worse.

What are the symptoms of migraines in children? — The symptoms of migraines can be different based on the child's age:

●In toddlers, symptoms include suddenly getting very pale, being less active than normal, and vomiting.

●In young children, migraines can cause nausea, vomiting, and belly pain, and make children sensitive to light and noise. The headache is often throbbing. It can affect the whole head or just parts of the head. For example, it might affect just the forehead or just the sides of the head.

●In older teens, the symptoms tend to be more like the symptoms adults get. The headache usually starts slowly and usually affects only 1 side of the head. But in younger teens, both sides of the head are often affected.

No matter what age, most children feel better if they lie down in a quiet, dark room while they are having a migraine.

Some children have something called a migraine "aura." An aura is a symptom or feeling that happens before or during the migraine headache. Each child's aura is different, but in most cases the aura affects a child's vision. As part of an aura, a child might see flashing lights, bright spots, zig-zag lines, or lose part of their vision. Another child might have an aura with numbness and tingling of the lips, lower face, and fingers of 1 hand. The aura usually lasts a few minutes to an hour and then goes away.

Many children get symptoms of migraine that happen several hours or even a day before the headache. Doctors call these "premonitory" or "prodromal" symptoms. The most common are fatigue, irritability, paleness of the face, and shadows under the eyes.

Some teenagers get migraines every month, around the start of their period. These are called "menstrual migraines."

Should my child see a doctor or nurse? — If your child has symptoms that could be a migraine headache, make an appointment with their doctor.

You should also call the doctor right away (without giving any medicine) if your child has a headache that:

●Starts after a head injury

●Wakes them up from sleeping

●Is sudden and severe or happens with other symptoms, such as:

•Vomiting

•Neck pain or stiffness

•Double vision or changes in vision

•Confusion

•Loss of balance

•Fever of 100.4°F (38°C) or higher

These things might be signs of a more serious type of headache. However, nausea, vomiting, and vision changes can occur with a migraine headache.

You should also take your child to see a doctor or nurse if they have a headache and:

●Get headaches more than once a month

●Are younger than 3 years old

Should my child have any tests? — Probably not. Your child's doctor or nurse will probably be able to tell what is causing your child's headaches by doing an exam and by learning about their symptoms. But if a doctor thinks your child might have a serious problem, they might order an imaging test such as an MRI or a CT scan. Imaging tests create pictures of the inside of the body.

What can I do to help when my child has a migraine? — When your child's migraine starts:

●Have your child rest in a quiet, dark room with a cool cloth on their forehead.

●Encourage them to sleep.

●Give your child only the medicine or medicines that you have talked to their doctor about.

How are migraines treated in children? — There are lots of prescription and non-prescription medicines that can ease the pain of migraines. There are also prescription medicines that can help prevent migraines from happening in the first place. The right medicine for your child will depend on how often they get migraines and how severe they are. If your child gets migraines often, work with their doctor to find a treatment that helps.

If your child has headaches often, do not try to manage them on your own with non-prescription pain medicines. Giving non-prescription pain medicines too often can cause more headaches later.

Some types of behavior therapy, such as relaxation exercises, might help to prevent migraines in some people. However, these might not help young children, and health insurance might not pay for them.

Is there anything I can do to keep my child from getting a migraine? — Maybe. Things that might help include good sleep habits, regular meal schedules, and regular exercise.

In some cases, migraines can be "triggered" or caused by certain foods or things that children do. Some possible headache triggers are:

●Skipping meals

●Not drinking enough fluids

●Sleeping too much or too little

●Stress

●Certain foods

●Being around smoke

If you can figure out what is triggering your child's headaches, you might be able to help them avoid those triggers. To find possible triggers, keep a headache diary for your child. In the diary, write down every time they have a headache along with the following:

●The times it started and ended

●Where in the head the headache was, for example, left side, right side, both sides, or behind the eyes

●How the headache felt, for example, "pounding" or "sharp"

●What your child ate and did before the headache started

●What you did to try to help, for example, having your child rest in a quiet, dark room

●What, if any, medicine you gave, including the name of the medicine and how much you gave

●Any other symptoms your child had with the headache, for example, seeing flashing lights

After you have been keeping a diary for a while, check to see if there are any foods or events that seem to bring on a headache. Then, try avoiding those triggers to see if headaches happen less often. Share the diary with your child's doctor or nurse. It can help them understand your child's headaches and choose the best treatment for your child.

More on this topic

Patient education: Headaches in children (The Basics)
Patient education: Headaches in adults (The Basics)

Patient education: Headache in children (Beyond the Basics)
Patient education: Migraines in adults (Beyond the Basics)