Kids with migraine endure the same obstacles to getting relief from their pain as adults do. Many myths and beliefs persist in our culture that make it difficult to get a proper diagnosis and treatment. Children with migraine may downplay the impact of their symptoms on their activities and schoolwork. Family and friends may not recognize that mood changes and isolation are actually due to migraine. If your child’s or teenager’s headaches are not well-controlled and are affecting his/her quality of life (e.g., missing school, missing social activities, and/or causing adverse mood changes), the first step in migraine care for children is to seek the help of a healthcare provider.
Prepare for your visit
It is very important to keep a headache diary or headache calendar to help the HCP make the correct diagnosis and recommend the appropriate treatment. The calendar should include the following:
- Frequency of the headache episodes
- Severity and duration of each headache episode
- Number of days that pain medications (prescription or over-the-counter) are used to stop the headache
- Response to headache rescue/pain reliever medications
- Caffeine intake frequency
- Triggers – Are there certain factors that seem consistently to “trigger” headache attacks? Common migraine triggers include: sleep deprivation or “oversleeping,” menstruation, and abrupt weather changes)
When a young person is diagnosed with migraine, it’s important to understand that you are dealing with a benign (not dangerous) disorder. Migraine is certainly a serious problem, but there is usually nothing to fear. In nearly all instances, it is an episodic disorder that can be treated. When you visit your medical provider try to remember the following:
- Be prepared to describe in detail what your child experiences, when headaches began, whether/not they have changed over time, how often episodes occur and how long they last (this is where the calendar comes in handy).
- Ask for a specific diagnosis, such as migraine, cyclic vomiting syndrome or tension-type headache, etc.
- Ask for a clear treatment plan on which you agree with in writing—you and the school will need to understand it completely. You can then start working with the school nurse, teachers, coaches and other family members who spend time with your child.
- Ask for a follow-up visit about what to do if treatment is not working.
In general, laboratory and imaging tests are not needed to make a diagnosis of migraine. However, on a case-by-case basis, the practitioner may do further evaluation. For example, if you have an unusual history and/or the medical provider finds something when doing a physical examination on your child, the provider may want to obtain additional tests to rule out other possible causes of headache. These may include simple blood tests or neuroimaging studies (e.g., a brain MRI).
Finding the right medical provider
If your child’s headaches are not controlled despite recommendations from his/her primary care provider, reassess each step and make an appointment to discuss the plan. Consider a second opinion to learn about possible alternative management.
Often, going to see a pediatric neurologist or headache specialist who is comfortable with caring for children with headaches will lead to effective treatment. For help finding a medical professional in your area who specializes in migraine treatment for children, check out the American Migraine Foundation’s Find a Doctor tool. To learn more about pediatric migraine and other disorders, visit the AMF Resource Library.
Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.