4-8% of children will experience a migraine like headache

The hard part of identifying and treating pediatric migraine is that they present differently from adult migraine.

 

Q: How do I know if my child is having a migraine attack?

A: “Children can suffer from abdominal migraine which are much more focused around stomach pain and nausea rather than headache pain. They can also describe more whole head pressure rather than throbbing unilateral pain that we associate with migraine in adults. Childhood migraine attacks are also shorter than an adult migraine attacks, sometimes lasting minutes as opposed to hours or days.

 

Q: what should I do if I suspect my child is having a migraine attack?

A: “The first thing you should do is seek help from a medical professional to make sure that a migraine is in fact what you child is experiencing. Once that’s determined, depending on your child’s headache burden, you and the doctor will decide between an everyday medication to help reduce their headache frequency (a preventative medication) or if they just need an effective medication to end each headache as it comes (an abortive medication).”

 

Q: How is migraine diagnosed in children?

A: “Migraine in children are diagnosed primarily based on history and physical exam. If the child has a story consistent with migraine, has normal physical and neurological exam, and a family history of migraine, then oftentimes no further testing is needed. I there are any “red flags” or worrisome components of the history (fever, sudden onset) or the exam (stiff neck, confusion) then further testing such as an MRI  or lumbar puncture may be necessary.”

 

Q: When do children tend to begin having migraine attacks?

A: “Migraine symptoms generally start around adolescence although they can certainly begin sooner. Generally speaking, migraine attacks peak in boys in their teenage years and then they tend to “grow out of them”. More often,  girls start experiencing migraine attacks around menstruation and then, unfortunately, grow into them as they continue throughout their child-bearing years”.

 

Q: What triggers pediatric migraine attacks?

A: “Migraine in children are triggered by similar situations as adults. Skipping meals, being dehydrated, or over-tired are classic examples of scenarios likely to trigger a migraine. If you suspect your child is having migraine attacks, see if you can identify triggers and reduce them. Make sure your child eats multiple protein filled meals a day, drink plenty of water, get a good night’s sleep each night is a few of the ways that you can help reduce their headache burden.”

 

Some migraine simply require medication. While over-the counter medication like Ibuprofen may help a low-level headache, a true migraine often needs stronger, more specific therapy. While we have a number of good options for adults, there are not that many migraine-specific treatment choices that are FDA approved for children and adolescents.