Learn how migraine affects children, what treatments are available and how to help your child manage their migraine
Migraine in children can sometimes be difficult to spot. There’s no blood or bruises, no fever or chills, no broken bones—but the pain can be immense.
Almost 60 percent of children complain of headache at some point. On top of that, about 10 percent of children experience the pain and disability of migraine. Migraine is not just a headache; it’s a disabling neurological disease that affects people of all ages.
Although migraine in children is the same disease that affects adults, it can impact children in different ways. Knowledge of the disease allows parents to help their child manage triggers and explore treatment options.
What are the symptoms of migraine in children?
How can you tell if your child’s head pain is migraine? The symptoms vary from person to person. But if you agree with some or many of the statements below, your child’s head pain may be migraine and you should think about seeing a doctor.
- The head pain associated with migraine is typically moderate-to-severe.
- Head pain can be one-sided and throbbing. But often, this is not the case in children and teens. They may complain of a steady, bilateral pain that is often—but not always—above the eyes.
- A migraine attack can last from one hour to several days. Often, children’s attacks are shorter than adults’.
- Associated symptoms commonly include nausea, vomiting, light sensitivity and sound sensitivity.
- Some children describe other symptoms such as having difficulty focusing, blurred vision and lightheadedness or dizziness.
- Some children experience abdominal pain with an attack.
- Head pain is severe enough to make a child miss school or other activities (or it keeps them from being at their best when they do those activities).
- Depression or irritability in a child can sometimes be a symptom of migraine, although this is very uncommon.
A minority of children will also have an aura preceding the onset of the migraine. Auras are usually a visual disturbance, but it can affect speech or involve feelings of numbness in the face and arm.
Migraine is further classified based on the frequency at which attacks occur. Episodic migraine describes patients experiencing fewer than 15 headache days per month. Chronic migraine is for when patients have more than 15 headache days per month.
What causes migraine in children?
Migraine is hereditary, so if one or both parents has migraine, there is a 50-75% chance their child will be affected. Knowing their family’s medical history, especially if it involves migraine, can help younger generations get an early and accurate diagnosis.
Most children with migraine will have spontaneous attacks. In other words, there is nothing they did or didn’t do to trigger the attack. This is just how the disease behaves. Some children will have attacks that have a clear cause or trigger.
Everyone has different triggers, but there are a few common causes that affect a large number of people. Common triggers include stress (good or bad), certain foods, skipping meals, sleeping too much or too little, changes in weather or barometric pressure, hormonal changes, concussions and traumatic brain injuries.
Migraine is especially common in females, and they are more likely to start experiencing attacks when they get their first period. Overall, three times more females live with this disease than males. Hormones play an important role in migraine, but there isn’t a clear picture on their role.
How do we diagnose migraine in children?
There’s no blood test or scan (ultrasound, CT scan, X-ray, or MRI) that will tell your doctor if your child’s head pain is migraine. The only real way for your doctor to know is to talk to your child about the specifics of their head pain, their response to current and previous treatments, their family history, and how their head pain affects their daily functioning and quality of life.
For the most part, children with migraine do not need imaging. But there are some situations in which getting an MRI is a good idea. Typically, imaging can be helpful if a child under 3 is having headaches, if the child presents with a new headache type that is severe, if the child exhibits symptoms associated with the headache such as changes in vision or swallowing, and if the child has weakness or changes in how they walk. Their provider might find changes in their physical exam that might indicate a MRI is necessary. Learn more about when imaging is necessary for a child with migraine.
Migraine can be a hard-to-understand disease, and children often have questions about their new diagnosis. Learn more about how to answer your child’s migraine questions.
What treatments are there for pediatric migraine?
The treatment of migraine in children typically involves multiple components. Children tend to benefit from an overall healthy lifestyle. As the first step in headache management, most physicians will educate families on practices that may help their headaches. That includes getting an adequate amount of sleep on a regular schedule, avoiding skipping meals, getting more exercise, staying well hydrated and managing stress.
Another part of treating pediatric migraine is identifying effective medications children can take at the onset of headaches for pain relief. This is what we call an acute medication. The typical goal is pain relief within one hour and the ability to resume or continue daily activities. Typical acute headache medications include over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen. Prescription medications such as triptans (sumatriptan and rizatriptan are two examples) also work.
Children who get more than one migraine attack per week may also get additional medication to reduce the frequency and severity of their migraine attacks. These preventive medications (i.e., amitriptyline, topiramate) or supplements (i.e., magnesium, riboflavin) are taken every day (even on days that children do not have headaches) and are usually given over a course of several months.
How can parents help their child with migraine?
Having an open and ongoing dialogue with your child to make sure that you’re all on the same page and they’re receiving appropriate care is key to caring for your child with migraine.
In school, missed classes and poor grades can all be signs that your child with migraine is struggling. Parents should get involved. Pay attention to your kid’s grades and class attendance, and tell teachers and school nurses about your child’s migraine. You can also help by educating your child’s teachers and school nurses about migraine and advocating for accommodations.
Parents should encourage their child to be open and honest with their friends about their migraine attacks. This can often be a tall order, especially for older children, but will ultimately be beneficial to your child.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Pediatric Migraine Resource Hub. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.