Doctor's Notes on Migraine Headache in Children
Migraines are severe headaches that usually occur with throbbing pain generally experienced on one side of the head and may last several days or weeks. Children with a migraine attack may look ill, have abdominal pain, vomiting, and have a strong need to sleep. When awake, they may show pain by being irritable, crying, rocking their body and seeking dark places to sleep. Children with migraines are often asked to describe how the headache feels (symptoms of the headache pain or discomfort being throbbing, pounding, squeezing, burning, stabbing, aching or pressure like). Some patients may have an aura (a sensation of light flashes, sounds or other sensations) right before the headache begins. Some children may show abnormal sensitivity to light and/or sound during the migraine. Others may also have tenderness in the scalp over where the pain is most severe. These signs and symptoms may occur in other conditions so it is not unusual for children to undergo testing to rule out other causes.
The exact cause or causes of migraine headaches in children is not known. However, some migraines are thought to be due to a low level of serotonin in the brain. Many migraine patients learn that their migraines can be triggered by things they may eat, drink or do physically. Although we don’t know why these triggers work, identifying such triggers can help reduce the occurrence of migraine headaches. Consequently, some common triggers that may cause migraine headaches in both children and adults to occur are listed below: Chocolate, cheese, nuts, shellfish, alcohol, caffeine, sugar, and monosodium glutamate in Chinese food.
Migraine Headache in Children Symptoms
A headache may be a symptom of a benign (relatively harmless) condition, or it may be a life-threatening symptom. The patient's medical history and physical examination results are often enough to identify or rule out serious underlying problems or conditions. Testing (laboratory or imaging) is employed to support a suspected diagnosis.
No specific laboratory or radiological test establishes the diagnosis of migraine headache. Doctors make the diagnosis through medical history, physical examination with emphasis on the neurological components, and clinical judgment. When considering a diagnosis of migraine headache, the doctor will ask about a child's medical history, previous tests, allergies, and current and previous medications.
- Children will be asked to describe how the headache feels (for example, throbbing, pounding, squeezing, pressing, pulsating, aching, burning, stabbing, dull).
- They will also be asked about the headache's location, timing, severity, causal events (for example, concussion, falling down), duration, and whether any relatives have migraine headaches.
- Other common historical evidence to support the diagnosis of migraine headache includes sensitivity to light and sound, tenderness in the scalp (usually where the pain is most severe) and a strong desire to lie down and sleep.
Conditions that cause severe headaches in children include both primary and secondary disorders.
Migraine Headache in Children Causes
The exact cause(s) of migraine headaches is unknown. Some migraines are thought to be due a temporary deficiency of the brain chemical serotonin. Many of the drugs effective in treating migraines target this chemical. Some migraineurs know that their headaches are triggered by something they eat, drink, or a particular activity.
The most common triggers include:
- Chinese food (commonly containing MSG -- mono sodium glutamate),
- sugar, and
Migraines most likely have several trigger factors and multiple internal causes. Although many migraine disorders do not develop until middle age, early recognition of migraine risk factors may help a child adopt a healthy lifestyle.
After an intense headache cost tennis star Serena Williams a tournament match, she learned her pain was related to her menstrual cycle. "I'd never heard of [menstrual migraine headaches] before," she says. "All this time, I thought it was a regular migraine." About 60% of women with migraine heaches say it gets worse during their periods, and hormones may be to blame. Your doctor may suggest medicines to even out your hormone levels.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.