Learn the warning signs and how to interpret symptoms
As much as we would like to protect our children from pain, the sad reality is that children are not immune to migraine. In fact, up to 10% of school-aged children experience migraine and its debilitating effects. Despite the numbers, many children are not getting the help they need, either because of improper diagnosis or treatment. Identifying migraine in kids helps parents become stronger advocates for their children to get them the help and treatment they need.
The real trouble is that kids don’t usually talk about their head pain, generally due to stigma or lack of understanding. Combined with the fact that migraine doesn’t always look the same in children as in adults, the behavior that results from their pain can make them appear undisciplined or anti-social.
Parents need to be on the lookout for any potential signs of migraine in their child. By understanding what migraine is, learning to identify the symptoms and knowing when to take them to their doctor, parents can start their children down the road to treatment.
Differing symptoms in adults and children
When it comes to identifying migraine in kids, it can be challenging to determine if a child is suffering from migraine or another ailment because their symptoms and the way they react to them often differ from those of adults. Further complicating the diagnosis, children may have trouble communicating the symptoms they experience before, during or after a migraine attack.
While children may experience many of the same symptoms as adults—dizziness, fatigue, nausea and sensitivity to light or sound—they are also more likely than adults to experience abdominal migraine, which can cause pain in their abdomen, nausea and vomiting. These migraine attacks are most common in children between the ages of 5 and 9, and can last less than an hour to several days. Colic in infants has also been linked to migraine later in life, indicating that it may be the earliest sign of the disease.
There are some noticeable differences in pediatric migraine when comparing symptoms between children and adults. Specifically, in children:
- The headaches may be shorter than in adults, lasting only an hour or two. Frequently, they last less than twelve hours.
- The episodes don’t occur as often as in adults. For example, they may happen only once a month or every few months.
- The headaches may go away after a few months or years.
- The pain tends to be more bi-frontal (across the forehead) than unilateral (on one side of the head). As children get older, the pain tends to be more unilateral.
Piecing the puzzle together
Children experiencing migraine may not always be able to describe what they are feeling, so it’s important for parents to help provide information. With careful observation and insightful questioning, you can get a clearer understanding of your child’s headaches and help get the right diagnosis.
It’s important to ask questions in a way that your child is able to comprehend. For instance, if you ask direct questions such as, “Are you sensitive to light or sound?” younger children may not understand what you mean. Sometimes rephrasing the question or watching their behavior may provide a better view of potential headache symptoms. For example, a child with light sensitivity may not want to play outside or watch TV because “the light is so bright.” Asking your child to draw a picture of what they are feeling can sometimes help express what they are unable to put into words.
Nausea is another symptom that’s difficult for a younger person to identify or explain. Ask your child, “Are you nauseated?” and there’s a good chance they won’t understand your question. Even if you ask, “Are you sick to your stomach?” they might not know what you mean. You may notice, however, that they simply do not want to eat or say that their stomach feels bad. By watching their behavior, you also can help identify what your child may be experiencing when they have a migraine attack. For instance:
- Watch to see if they go into a quiet place to rest or even nap.
- Notice if they talk to you less than usual or have a mood swing.
- Watch for a change in their daily routine. They may not engage in their usual reading or television activities because their eyes hurt or focusing is more challenging.
- Be aware of when they resume their normal activities.
A family affair
Migraine is a genetic disease, so if you’re a parent with migraine, it’s especially important to be mindful of signs that your children may be exhibiting similar symptoms. An overwhelming majority (about 70%) of children and adolescents who experience migraine have an immediate family member who also has migraine or had it when they were children.
Many adults, however, don’t realize that their headache is actually a migraine. Only 48% of adults receive a migraine diagnosis—so it’s very possible that a parent might not realize when a child’s “regular” headache is actually a migraine.
Other kinds of migraine in children
When they’re fairly young (2 to 8 years old) and before they complain of headache, children may get other childhood migraine syndromes/variants. The two most common are abdominal migraine and cyclic vomiting syndrome.
Abdominal migraine is similar to migraine, except instead of headache, children complain of stomachaches. The location of the pain can range from being a general discomfort to presenting as cramping around the belly button or all over the stomach.
Cyclic vomiting syndrome consists of episodes of vomiting with predictable repeat episodes weeks later. These can be very dramatic, can lead to dehydration and may/may not be associated with headache.
While these conditions are very real and can affect children, episodic abdominal pain or vomiting may be due to a gastroenterological problem and be unrelated to migraine. It’s a good idea to have a gastroenterologist assess your child before initiating migraine therapies.
Identifying migraine in kids
If you have a child who experiences bad headaches that you suspect might be migraine, make an appointment with a migraine specialist for a proper diagnosis. It may make all the difference. For help finding a doctor experienced in identifying migraine in kids in your area, check out the American Migraine Foundation’s Find a Doctor tool. For more information about pediatric migraine, visit the AMF Resource Library.
This blog was updated in March 2020.