Children and Headaches
One of every four children will complain of headache pain by the age of 15. What parents might not know is that this common gripe, often dismissed with a painkiller and a nap, may actually be the beginning of a lifetime of much harder-to-manage migraine pain.
Ten percent of adolescents are victims of migraine pain, and 70 percent of those adolescents will continue to have some degree of migraine pain for the rest of their lives. This debilitating condition can negatively impact a child's day-to-day activities, affecting their school performance as well as social and personal growth. Children who suffer from migraines miss two to three times more school days, have more difficulty concentrating on schoolwork, and miss out on more extracurricular activities than children without migraines.
Diagnosis and Symptoms
Migraines can be difficult to diagnose in adolescents because parents, and even doctors, can misread signs and symptoms. Symptoms present themselves differently in children than in their adult counterparts, so classic migraine indicators are not necessarily applicable to pediatric migraine cases.
Children typically have shorter migraine attacks (sometimes as little as an hour) and feel pain on both sides of their head (bilateral). Adults can experience migraine attacks for days at a time and usually suffer pain only on one side of the head (unilateral). Children may also have difficulty describing the type and extent of the pain they are feeling, leaving out words like "throbbing" or "pulsing," which are key descriptors for adults complaining of migraine pain.
Being aware of a child's behavior is vital when looking for signs of migraine. For example, refusal to eat may be due to nausea, and an insistence on turning off the lights during a headache is likely due to photophobia, or sensitivity to light - both signs that the headache may be a migraine.
Children and Head Pain: Reading the Early Signs of Migraine
In young children, episodes that include cyclic vomiting, abdominal pain, and vertigo and last for hours or days may be indicators that the child will develop migraines later in life. Other neurological deficits such as abnormal eye and neck movements and weakness on one side of the body can be due to migraine and should be treated as an emergency until otherwise advised by the patient's doctor.
If a child is having a hard time describing the kind of headache pain she is feeling, it may be beneficial to have her draw a picture or rate her pain using a tool like a face scale to better assign severity.
Steps to a Solution
Addressing lifestyle factors such as diet, exercise, and sleep habits can help reduce the frequency of migraine pain and cultivate lasting, healthy habits in children at an early age. Other approaches to migraine management include relaxation techniques, talk therapy, biofeedback, and the use of natural supplements. While there are prescription medications to help manage pain, most are not approved by the FDA for use in children, and the decision to administer such medication must be undertaken with serious consideration and care by the treating physician and family.
With careful attention to a child's complaints and behavior, pediatric migraines can be diagnosed, treated, and managed quickly and successfully.
When to Seek Medical Attention:
1. Head pain persists more than one hour and is not relieved by OTC pain medicine or a nap.
2. Head pain is combined with hours of vomiting, vertigo, or loss of appetite.
3. Head pain is associated with stiff neck, fever, lethargy, or any neurological symptoms such as paralysis, funny eye movements, difficulty speaking, or clumsiness/loss of balance.
Children Are More Likely to Suffer Migraines If:
1. One or both parents suffer from migraines.
2. Siblings or even grandparents, uncles, aunts, or cousins suffer from migraines.
3. They have suffered from a head injury or other neurological conditions such as epilepsy.
Common Migraine Triggers in Kids:
1. Weather changes
2. Lack of sleep
3. Skipping meals, particularly breakfast
4. Eating foods that contain nitrates or MSG
5. Exercise in some people (so watch for migraines during or after afterschool sports)
Tips for Avoiding Headache and Migraine:
1. Work on good sleep hygiene with kids, emphasizing consistent bedtimes, even on weekends, and same wakeup times, too.
2. Eat a healthy, well-balanced breakfast, lunch, and dinner each day, along with nutritious snacks. Avoid foods such as cured meats and hot dogs, which contain nitrates and MSG.
3. Wearing helmets when engaging in risky sports not only helps reduce the risk of serious head injury, but also of milder head injuries that can trigger migraines as well as other types of headaches.
Dr. Audrey Halpern is board-certified in headache medicine by the United Council for Neurologic Subspecialties, and in neurology by the American Board of Psychiatry and Neurology. Dr. Halpern offers unique methods for treating and preventing migraines, offering visits at Manhattan Headache and Neurology in addition to house calls. Manhattan Headache and Neurology is located at 35 East 35th Street, Suite 206, Manhattan. 646-648-3793 or www.ManhattanHeadache.com.