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Kids and Migraines

Headache is the most frequent neurological symptom and the most common manifestation of pain in children.  Because children are less likely to articulate their problem or seek help their needs are often unmet.  Children who suffer from headaches may have difficulty concentrating on their school work and often experience more missed days and more frequent doctor visits.

As a child, you know when teradactyls flew around, I had headaches almost daily.  They were diagnosed as vision problems and resolved with glasses so that is a great place to start.  As an adult I developed serious migraines with my cycle.  Unfortunately I must have passed that on to my daughter.  In her adolescent years she started with spots in front of her eyes referred to as “aura” followed by nausea and vomiting.  Most children do not experience aura but they will often have a headache preceded by mood changes or withdrawal from activity.

If your child suffers from headaches and complains about sensitivity to light or sound or the headache is accompanied by nausea or vomiting they are probably experiencing migraines.  In one study of over 48,000 children with headache 80% of the primary headaches were migraines.

As a mother we always worry about our children and the concern with headaches in children is often that there is something serious causing it.  The goods news is that the risk of a malignant tumor in pediatric migraine patients is very minimal.  In the study mentioned above the risk of malignant tumor was 0.03% compared to 0.004% in the control group.

Realizing that the pain, although unpleasant, is not life-threatening often allows for healthier coping strategies.  Sleep, darkness, and a quiet room are essential in managing acute migraine and tension-type headache. Scheduled times for meals, bedtime, relaxation, and exercise should be encouraged as well as relaxation techniques.  Sometimes even the focus of a video game can provide relief,

The role of diet in headaches remains controversial. However, if a given food or beverage is associated with headaches, its avoidance has an obvious and significantly positive impact.  Alcohol, drugs, or caffeine may trigger headaches and appropriate lifestyle changes should be encouraged.  If stress or family situations are causing the migraines consider therapy to learn healthy coping mechanisms.

  • Factors that precipitate migraine
    • Common factors
      • Stress/anxiety
      • Menstruation
      • Oral contraceptives
      • Physical exertion/fatigue
      • Lack of sleep (sleep apnea may also be a primary cause of headache)
      • Glare
      • Hunger
      • Foods/beverages with nitrates, glutamate, caffeine, tyramine, salt
    • Less common factors
      • Reading/refractive error
      • Cold foods
      • High altitude
      • Drugs – Nitroglycerin, indomethacin, hydralazine

The bad news is that there is no approved medication for pediatric migraine.  There are studies currently underway that are investigating the affect of new medications on migraines in the pediatric population.  If your child suffers from migraines you know how important this research is.  Look on –line for information about migraine studies in your area.  If you are in the Tampa Bay area go to www.dmiresearch.com for a pediatric migraine study.

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