People of all ages experience migraines, and the symptoms in children are similar to those in adults. They can include moderate to severe headaches, nausea, vomiting, and sensitivity to light and sound.
The underlying mechanisms of migraines in children are unclear, but genetics may play a role. Also, about half of the children who suffer from migraines stop after puberty.
In this article we describe the symptoms, causes and treatments of migraines in children.
About 3-10% of children suffer from migraines. Prevalence increases with age until puberty, when about half of these children or young teens stop having migraine episodes.
If the migraine symptoms begin during adolescence, the person is more likely to continue to experience the condition into adulthood.
Before puberty, migraines affect men as well as women. After puberty, women are more likely to experience it.
Children with migraines experience many of the same symptoms as adults. These can include:
- headache that lasts 2-72 hours
- headache on one side of the head
- moderate to severe pain
- pain that gets worse with physical activity
- sensitivity to light or sound
- nausea or vomiting
- aura, sensory disturbances such as flashing lights in the field of vision which may be the first symptom
According to the UK’s National Migraine Center, children are more likely to experience pain in multiple locations or all over the head, compared to adults.
Also, episodes in children can be shorter than those in adults.
It can be difficult to diagnose migraines in young children, who may not be able to describe their symptoms. Another challenge concerns the subjectivity of pain intensity – children and their parents or caregivers may have little or nothing to compare. For these reasons, doctors rarely diagnose migraines in children under the age of 2.
Finally, it is worth noting that in some people with migraines, a headache is absent or a minor symptom.
Researchers don’t know why some kids get migraines and others don’t. However, many kids with migraines have family members with the condition, suggesting there is a genetic component.
Experts know that certain genetic mutations predispose children to certain types of migraines. For example, if a child has hemiplegic migraines, a type that causes temporary weakness and paralysis, they could have a mutation in one of the following genes:
Research into the causes of other types of migraines is ongoing.
People with migraines often find that certain foods, situations, or environmental factors trigger migraine episodes. Identifying these triggers can often help prevent episodes.
However, identifying the triggers can take time. It’s also worth noting that different triggers often overlap to contribute to the development of a migraine episode.
Keeping track of a child’s migraine symptoms and possible causes can help. We provide specific ideas on what to note in the “Home Care” section below.
Common triggers to consider include:
- Changes in sleep patterns: A child can have an episode if they sleep too much or too little. Establishing and maintaining a regular sleep schedule can help.
- Dehydration: Making sure a child drinks enough water, especially after physical activity, can help reduce migraine symptoms.
- Food and drink: Specific foods can cause symptoms and thus undereating. Note what a child has eaten on days when they have symptoms and check for a cartridge.
- Voltage: Stress and overstimulation can contribute to migraines. If a child often feels stressed and anxious, they may benefit from having a quiet space where they can calm down. Mindfulness activities for kids can also help.
- Environmental triggers: These can include weather changes, secondhand smoke, and bright lights, for example on computer or phone screens.
Not all migraine triggers are avoidable, but avoiding them whenever possible can decrease the frequency of episodes.
If a child is experiencing migraine symptoms, a doctor may recommend an appropriate dosage of over-the-counter (OTC) medications, such as:
However, these drugs and dosages are not always suitable for children. Consult a doctor or pharmacist before administering over-the-counter medication to a child.
If a child is experiencing frequent or severe migraine episodes, a doctor may also prescribe a medication from a family of medications called triptans. These work specifically to prevent migraine episodes.
The Food and Drug Administration (FDA) has approved sumatriptan (Imitrex) and rizatriptan (Maxalt) for use in children.
If a child does not respond well to triptans, the doctor may prescribe the following:
- beta blockers
- amitriptyline (Elavil) or nortriptyline (Pamelor)
- anti-epileptic drugs
Some children may also respond to relaxation training or biofeedback.
In addition to administering medication and helping to prevent exposure to triggers, health care providers and children can use other strategies to help manage migraine symptoms:
During an episode
If migraine symptoms occur, try:
- move the child to a quiet, darkened room
- applying cool or warm compresses to their heads
- offering them an eye mask to keep out light if they are sensitive to light
- massaging tense or painful muscles
- encourage the child to sleep if this helps with the symptoms
Anyone who keeps a symptom diary should keep an eye out for:
- the time and date when symptoms occurred
- the length and severity of the episode
- whether treatments or strategies have helped
- any triggers
Preparation
Being prepared for migraine episodes can help limit their effects. A person can:
- Make one or more migraine kits, including items such as medication, hot or cold compresses, an eye mask, water, and a symptom diary.
- Learn about possible triggers and identify specific ones.
- Help identify any warning signs that symptoms are occurring.
- Inform schools, daycares, and other health care providers about the child’s experiences and what to do if a migraine episode occurs.
It’s worth keeping in mind that taking painkillers as soon as possible can help stop the progression of the migraine episode.
Emotional support
It can be difficult to assess the extent of a child’s migraine symptoms. Depending on their age, they may not understand or fear their condition.
During an episode, it’s important to be reassuring and calm. After that, it may help to teach the child about the condition or to have a doctor explain it.
Understanding what migraines are and that each episode ends eventually can ease some fears. It can also help the child take a proactive role in managing the condition, such as keeping or assisting in a symptom diary.
Contact a doctor about a child’s migraine symptoms. They can prescribe medications to reduce the severity and frequency of episodes. It’s also important that they rule out other possible causes of the symptoms.
Some migraine symptoms resemble those of more serious health conditions. Seek emergency medical attention if a child experiences:
- a sudden, severe headache without other migraine symptoms
- headaches with the worst pain they have ever experienced
- headache after a head injury
- headache and any of the following:
- A stiff neck
- confusion
- an epileptic seizure
- loss of consciousness
Talk to a doctor right away if a child has symptoms in addition to migraines:
- changes in vision, balance, or coordination
- excessive vomiting
- persistent pain
- a recent change in personality or behavior
Any of the above can indicate a different underlying condition.
In children, migraines are not uncommon, and symptoms can appear at an early age. Taking OTC pain relievers once symptoms develop can stop or limit their effects. A doctor can prescribe targeted migraine medications instead.
It’s important to get medical attention for any migraine symptoms. A doctor must be sure of the cause, as some symptoms are similar to other health problems.
In addition to prescribing medication, the doctor can provide advice on identifying triggers and managing episodes.