Migraine headaches are one of the most common worldwide disorders, occurring with increasing frequency from childhood right through to old age. But it is one of the most under-diagnosed conditions and so remains a serious issue for millions of kids.
A headache is something that most people will experience from time to time. What differentiates a transient headache that will clear up on its own with simple treatment and a migraine attack is that a migraine may be totally debilitating, repetitive, and get worse over time.
For children and teenagers, it’s even harder to tell the difference when they complain of discomfort. They have no frame of reference to report whether the degree or length of the attack marks it as a migraine. Complaints of pain may cause parents to seek immediate relief for their child, so trying to diagnose whether the symptoms that indicate a migraine are overlooked in favor of taking steps to minimize their pain.
Parents should tell their children that it’s important to report if they have a severe headache because that is not normal. They need to seek help from their doctors, and their child needs to know that support is available. Parents also need to be totally sympathetic, with raised awareness of the possibility that the child is reporting a serious problem and not just playing around.
It can be helpful to keep a migraine diary so you can work out what the triggers are. The diary should say something about the day’s events, down to the level of special activities, foods or disturbances and include the severity and occurrence.
Once you build up a pattern of what are the triggers, you can alter your child’s lifestyle to minimize them. This can help reduce the frequency of the migraines although it might not eliminate them altogether.
Main medications for migraine in children and teenagers
Although migraines are not curable, several medications can relieve the acute pain or shorten the duration of a migraine attack. The main form of the medications is based on triptans, which work by stimulating serotonin receptors (5HT receptors) in the brain. Natural serotonin acts on these receptors and causes blood vessels in the brain to constrict. Triptan mimics this action by directly stimulating the serotonin receptors. These drugs are also prescribed for adults with migraines, but the dosages are adjusted according to the child’s age and body mass.
|Amerge/Naramig (naratriptan) is a triptan that works in the same way as Relpax and Maxalt and others
|Relpax/Relert (eletriptan) Belongs to the group of triptans
|Imitrex / Imigran (sumatriptan) is a triptan that works in the same way as Relpax, Amerge and others – dosage usually along with naproxen up to 80/500mg for older children.
|Maxalt (rizatriptan) is a triptan that works the same way as Imitrex / Imigran, Zomig and others
|Zomig (zolmitriptan) is a triptan that works the same way as Imitrex, Maxalt and others – dosage for children usually 5 mg
At what ages do migraine occur?
Migraine can affect people of all ages, but it usually starts in the early teenage years. Some younger children may suffer migraine attacks, but they may be of shorter duration and not associated with symptoms as severe as are typically seen in later years.
Studies report that up to the mid to late teens, around one in ten boys get migraine headaches, and around half as many girls. By the early twenties, that ratio is reversed and about one in five girls report recurrent migraines, compared to about one in six boys. Throughout adult life, the ratio of females to males keeps increasing until in later years, nearly three times as many women are suffering from migraines as men.
Can migraines run in families?
Migraines often occur in members of a family, and some genes that could be the cause of inherited (familial) hemiplegic migraines have been identified. A single copy of the altered gene (autosomal dominant pattern) can cause the disorder but some people who do have the altered gene never develop migraines.
Apart from these, no other specific genes have been associated with migraines, so the underlying causes of migraines remain unclear.
Along with an inherited gene, environmental factors may cause migraines to run in families where people share the same living space and experiences. The common triggers of migraines often have to do with lifestyles, so people living in close proximity and sharing cultural and social living patterns may be subject to the same triggers for migraines.
The common lifestyle triggers, and how to avoid them, are:
|It is essential to get enough quality sleep – around 8 or 9 hours for children and teenagers. Establishing a regular sleep-wake cycle with regular bedtimes and waking times can help.
|Drinking caffeine-loaded beverages regularly can create dependence, triggering severe headaches when you don’t get it. Avoiding caffeine in general is advisable, limited to just an occasional soda or beverage.
For some people, caffeine can help at the start of a headache.
|Increase water intake if active or sweating. Try to drink enough to need the restroom at least every 2 to 3 hours.
|Bad posture can trigger headaches by placing excessive strain on the neck, shoulders, and upper back muscles. Looking down onto smartphones and tablets can cause headaches. Use a comfortable position and take frequent breaks.
|Missed meals can trigger headaches for some people. Some people have specific food triggers for headaches, including bananas, strawberries, chocolates, foods with MSG (processed meats), red wine or pungent cheeses. Limit intake of sugary beverages and sweets.
|Heat & Sunlight
|Hot weather, bright lights or sunlight can be a headache trigger. Avoid long periods in direct sunlight, and wear sunglasses and a hat outdoors.
|Stress is a widespread trigger. Identifying and managing stress is critical. There are many ways to manage stress, such as:
Are there warning signs of a coming migraine?
In young children, migraines most frequently come in the late afternoon, but as the child ages, they more often begin in the early morning.
In some people, a strong indicator of a coming migraine is an aura lasting about 20 minutes, which starts about half an hour before the migraine itself. The most common auras are visual, such as blurred or distorted vision, blind spots, brightly colored and flashing or moving lights or lines. Other auras may include changes in speech, movement, hearing, smell, taste or touch.