Migraine Headache in Children (cont.)
Migraine Headache in Children More Medical Treatment
An estimated 20% to 50% of migraineurs (people who have migraines) are sensitive to foods. These dietary triggers are thought to cause a change that provokes a migraine attack. Helping children learn to recognize and avoid these triggers is helpful but often difficult. The following are some common dietary triggers:
- Tyramine: Individuals
with low levels of a substance called phenol sulfotransferase P are believed to be sensitive to dietary monoamines (a type of
molecule) such as tyramine and phenylethylamine. Cultured dairy products (for example, aged cheese, sour cream, buttermilk), chocolate, and citrus fruits are believed to cause
vasodilation (widening of
the blood vessels) in certain people. Some migraines may be triggered by
- Beverages: Alcoholic
beverages (especially red wine) and excess of or withdrawal from caffeinated
drinks such as coffee, tea, cocoa, or colas may trigger a migraine headache.
Migraineurs should limit caffeinated sources to no more than two cups per day
to prevent caffeine-withdrawal headaches. Caffeine can be found in
chocolate-containing foods and candies; therefore, children with migraines
should avoid them.
- Nitrates and nitrites:
These vasodilating agents are found in preserved meats. Examples of foods
containing these chemicals include lunch meats, processed meats, smoked
fish, sausage, pork and beans with bacon, sausage, salami, pastrami,
liverwurst, hotdogs, ham, corned beef, corn dogs, beef jerky, bratwurst,
- Monosodium glutamate
(MSG): MSG is a flavor enhancer and vasodilator found in many processed foods. Food labels should be checked carefully. MSG sources include Accent seasoning, bacon bits, baking mixtures, basted turkey, bouillon cubes, chips (potato, corn), croutons, dry-roasted peanuts, breaded foods, frozen dinners, gelatins, certain Asian foods and soy sauce, pot
pies, relishes, salad dressing, soups, and yeast extract.
- Citrus fruits, avocados, bananas, raisins, and plums: These foods may be triggers. Although few individuals are sensitive to fruit, children with migraines should still eat a well-rounded, natural diet that includes fruits and vegetables and avoid processed foods. A headache diary may be helpful (a pattern often emerges after 6
to 8 weeks). Care must be taken to avoid creating an unnaturally limited diet that harms a child's growth and development.
Both OTC and prescription medications can trigger or worsen migraine headaches.
ranitidine (Zantac), and reserpine (Serpasil)
are examples of medications that can increase migraine frequency.
Excessive use of OTC pain medications and analgesics can cause occasional migraine attacks to convert to analgesic-abuse headaches or drug-induced headaches that do not respond to treatment. Children with migraines should avoid frequent or long-term use of NSAIDs, acetaminophen, triptans, or ergotamines. Migraineurs who have been treated for a long time with amphetamines (Biphetamine),
phenothiazine (a type of antihistamine), or
propranolol (Inderal) should avoid sudden withdrawal from these medications because migraine headaches may result.
In children who have an inborn tendency for migraine headaches, attacks can occur as a result of psychological (emotional), physiological (internal body processes), or environmental triggers. Physical exertion and travel or motion can be triggers.
- Psychological triggers: These include stress, anxiety, worry,
sadness. Migraine headaches are not an imagined or psychological illness.
Stress makes an underlying tendency for migraine more difficult to manage.
The frequency of migraines can be reduced but not eliminated by maintaining
a healthy lifestyle.
- Physiological triggers:
These include fever or illness and not getting adequate food, rest, or sleep.
Children with migraines should stick to a routine with regular meal times
and adequate sleep.
- Environmental triggers: These include fluorescent light, bright light, flickering light,
fatigue, barometric pressure changes,
strong odors, computer screens, or rapid temperature changes. Some
migraineurs report that complex visual patterns like stripes, checks, or
zigzag lines trigger their migraines.
- Physical exertion:
Activity can trigger childhood migraine. Some migraineurs report that they
are more likely to get a headache after participating in sports or being
extremely active. Minor head trauma (for example, being hit in the head with
a ball, falling on one's head) may also result in a migraine attack.
- Travel or motion: This may cause migraine, particularly in young children.
If headaches cannot be reasonably controlled within 6
months, the child should see a pediatric neurologist
(a physician specializing in the treatment of brain/nerve disorders). Children who suddenly develop new neurologic problems such as weakness, thinking difficulties, or seizures, should also see a pediatric neurologist.
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