Migraine headaches can begin at any age. However, the presentation of migraine in a child may be different than that of an adult. Migraine headache in adults is commonly associated with nausea, vomiting, and/or sensitivity to light and sound and can last for up to 3 days. In children, these symptoms may not be as obvious or may be mistaken for other disorders. As a result children often remain without a correct headache diagnosis for many years.
Since children can experience headaches and are not always able to describe what they are feeling, it’s important for parents to provide information. With careful observation, and insightful questioning, you can get an idea about your child’s headaches and help to get the right diagnosis. Asking your child to draw a picture of what they are feeling can sometimes help express what they are unable to put into words.
Migraine Headache Differences in Children
Headaches experienced by children may actually be migraine with or without aura. There are some notable differences in migraine when comparing symptoms between children and adults:
- The headaches may be shorter, lasting only two hours. Often children may want to go to sleep because of their headache and the time they are sleeping should be included as part of the duration of the headache.
- The episodes don’t occur as often. They may happen only once a month or every few months.
- The pain tends to be more across the forehead (bi-frontal) than on one side of the head (unilateral). As children and adolescents get older, the pain tends to be more unilateral.
- Children may not report many of the common symptoms normally associated with a migraine, such as sensitivity to light or sound. These symptoms may be inferred from their behavior (i.e. preferring to go lay down in a dark, quiet room).
- In young children even before they complain of headache, they may get other childhood migraine syndromes. These include benign paroxysmal torticollis, benign paroxysmal vertigo, cyclic vomiting syndrome and abdominal migraine. Some headache experts have even suggested that infant colic may be an early form of migraine. Please refer to the article “Connection between Migraine & Colic”.
- Cyclic vomiting syndrome consists of regular, predictable episodes of vomiting several weeks apart. These vomiting episodes can be very severe and can lead to dehydration.
- Abdominal migraine seems like migraine except instead of headache, children complain of stomachaches. The pain is vague or cramping around the belly button.
- Appropriate investigations should be completed prior to making the diagnosis of cyclic vomiting syndrome or abdominal migraine as episodic abdominal pain or vomiting may be due to other problems involving the gastrointestinal or urogenital system.
Getting Help for Your Child
If your child is experiencing headaches it is important to get the right diagnosis as soon as possible by having your child formally evaluated by their doctor or Allied health care professional. Once an accurate diagnosis is made, effective acute and if necessary preventive therapy can be given. Acute therapy should stop a headache or at least reduce the pain within 2 hours and preventive treatment reduces headache frequency and severity. If the initial therapies are not effective, consider seeing a Pediatric Neurologist or Headache Specialist who is comfortable in caring for children with headaches.