Understanding Pediatric Migraine

Why migraine in children is oftentimes overlooked, misdiagnosed and left untreated

Migraine in children and teens often goes untreated because, unlike adults, children have a more difficult time understanding the pain and disruption caused by their migraine. As a result, children with migraine are often asked to sit through school days even while experiencing severe symptoms—a truly devastating experience for children, and the parents who feel helpless in providing relief for their child. Christina Szperka, M.D., Director of the Pediatric Headache Program at the Children’s Hospital of Philadelphia, outlines some of the common symptoms and treatment options for pediatric migraine.

How common is pediatric migraine?

“Migraine is very common in children,” Szperka said. “We’ve learned that migraine occurs in about single-digit percentages of school-aged kids. It becomes much more common through adolescence, and that migraine can be disabling.”

Almost sixty percent of children complain of headache at some point, and about eight percent of children suffer from migraine. During the teenage years it occurs more frequently in girls than in boys, but prior to puberty migraine is equally common in the two sexes. In some children, headaches occur so frequently their condition qualifies as chronic migraine.

“There are children who have what we call chronic migraine because they have headache more than 15 days per month- more days than not,” Szperka says. “The rates are probably around 1.5 to 2%, depending on exactly how you define that. So if you think about that, two out of every 100 children means that there are lots of teenagers out there who have very frequent headaches.”

Pediatric migraine symptoms

Migraine symptoms vary between younger children and adults. “There are children who would have a more classic migraine presentation, very similar to what you think of as an adult presentation, where pain is a predominant symptom,” explains Szperka. “But in younger children we see more common GI symptoms including vomiting and stomach pain.”

In addition, while adults typically have one-sided headaches, children often experience pain on both sides of the head, and the headaches are commonly accompanied by sensitivity to light and sound.

Pediatric migraines are usually much shorter than adult migraines, making them hard to treat.

“Sometimes the child will develop severe pain and belly pain or nausea, and then vomit, and then the episode’s over,” Szperka says. Even though these episodes are brief, they are still extremely painful and disruptive for children.

Treatment options

Parents should rest assured knowing that migraine is common in children and adolescents, but they should also realize the severity of the pain their child could be experiencing, and work to seek proper treatment. Once a general practitioner has ruled out any serious conditions, parents can work with the doctor or a headache specialist to find a treatment plan that helps their child live life without migraine.

The American Migraine Foundation has an extensive collection of information related to headache in children and adolescents. Click here to view the pediatric migraine resource library, and use the searchable Find A Doctor database to connect with a specialist near you. For more information on caring for a child with migraine, download a free copy of our guide.

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