Migraines are a type of recurring headache that involves blood vessels, nerves, and brain chemicals. One type of migraine has no preceding aura. The other type comes with an aura. Auras are sensations that come before a migraine headache occurs. They commonly include visual changes, or numbness and tingling.
Migraine headaches can affect a child’s performance in school, relationships with friends and family, and other factors in a child’s life. Medication should be started as soon as symptoms (pain or aura) appear. This will lessen the length of the migraine and reduce the time with associated symptoms like vomiting.
Specific genes, especially those that run in families, appear to be associated with migraines. Other causes may include nerve or blood vessel problems, environmental triggers, or a chemical imbalance. Many times, the exact cause may remain unknown.
Some factors that can trigger a migraine include:
Migraines are more common in males before puberty and in females after puberty. The average age of onset is 7 years old (boys) and 10 years old (girls).
Factors that increase your child’s chance of migraines may include:
Migraines may occur in phases that may include:
A warning may come before a migraine. In the hours or days before the headache, symptoms may include:
The most common aura is visual. The aura lasts about 15-30 minutes. It may produce the following sensations:
Migraines can also occur without the presence of warning symptoms or an aura.
Migraine pain starts within an hour of the aura ending. Symptoms include:
You will be asked about your child’s symptoms and medical history. A physical exam will be done. Your child will also be given a neurological exam. The diagnosis is usually based on your child's symptoms.
Imaging tests may be done if your child's symptoms are severe or the neurological exam is not normal. These tests may include:
The goal of treatment is to:
Treatment includes a combination of therapies and may include:
Medications are considered first-line therapy for migraine headaches. The medications used depend on the severity of the headache and how the child responds to the treatment.
These may include:
Medications are usually taken by mouth, but may be needed as an IV in severe cases, especially with vomiting.
Therapy may also be used to reduce the length and frequency of migraine headaches. It may be used with or without medication and may include cognitive behavioral therapy, biofeedback, or relaxation methods.
To help during a migraine:
Keep a diary to understand what factors may trigger your child's migraines.
Some steps that may help prevent future migraines includes:
American Headache Society
The National Migraine Association
The College of Family Physicians of Canada
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Migraine—treatment of acute attack in children and adolescents. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T917653/Migraine-treatment-of-acute-attack-in-children-and-adolescents. Updated March 6, 2017. Accessed September 25, 2017.
Migraines. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/migraines. Updated April 2014. Accessed September 25, 2017.
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1/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T259238/Migraine-prophylaxis-in-children-and-adolescents: Powers SW, Kashikar-Zuck SM, et al. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA. 2013;310(24):2622-2630.
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Last reviewed September 2017 by EBSCO Medical Review Board Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.