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by Marjorie Montemayor-Quellenberg, MA
Migraines are a type of recurring headache that involves blood vessels, nerves, and brain chemicals. One type of migraine has no preceding aura. The other type comes with an aura. Auras are sensations that come before a migraine headache occurs. They commonly include visual changes, or numbness and tingling.
Migraine headaches can affect a child’s performance in school, relationships with friends and family, and other factors in a child’s life. Medication should be started as soon as symptoms (pain or aura) appear. This will lessen the length of the migraine and reduce the time with associated symptoms like vomiting.
Specific genes, especially those that run in families, appear to be associated with migraines. Other causes may include nerve or blood vessel problems, environmental triggers, or a chemical imbalance. Many times, the exact cause may remain unknown.
Some factors that can trigger a migraine include:
Risk Factors TOP
Migraines are more common in males before puberty and in females after puberty. The average age of onset is 7 years old (boys) and 10 years old (girls).
Factors that increase your child’s chance of migraines may include:
Migraines may occur in phases that may include:
A warning may come before a migraine. In the hours or days before the headache, symptoms may include:
The most common aura is visual. The aura lasts about 15-30 minutes. It may produce the following sensations:
Migraines can also occur without the presence of warning symptoms or an aura.
The Migraine Headache TOP
Migraine pain starts within an hour of the aura ending. Symptoms include:
A Post-Headache Period TOP
Migraines typically last from 4-72 hours. They often go away with sleep. After the headache, your child may experience:
You will be asked about your child’s symptoms and medical history. A physical exam will be done. Your child will also be given a neurological exam. The diagnosis is usually based on your child's symptoms.
Imaging tests may be done if your child's symptoms are severe or the neurological exam is not normal. These tests may include:
The goal of treatment is to:
Treatment includes a combination of therapies and may include:
Medications are considered first-line therapy for migraine headaches. The medications used depend on the severity of the headache and how the child responds to the treatment.
These may include:
Medications are usually taken by mouth, but may be needed as an IV in severe cases, especially with vomiting.
Therapy may also be used to reduce the length and frequency of migraine headaches. It may be used with or without medication and may include cognitive behavioral therapy, biofeedback, or relaxation methods.
Other Treatment During the Migraine TOP
To help during a migraine:
Preventing Migraines TOP
Keep a diary to understand what factors may trigger your child's migraines.
Some steps that may help prevent future migraines includes:
There are no current guidelines to prevent migraine in children since the cause is not known. If your child is prone to migraines, talk to their doctor about preventive medications.
American Headache Society
The National Migraine Association
The College of Family Physicians of Canada
Headache in children. National Headache Foundation website. Available at:
...(Click grey area to select URL)
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Migraine—treatment of status migrainosus in children and adolescents. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated March 6, 2017. Accessed September 25, 2017.
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Migraines. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/migraines. Updated April 2014. Accessed September 25, 2017.
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10/25/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Bruijn J, Locher H, Passchier J, Dijkstra N, Arts WF. Psychopathology in children and adolescents with migraine in clinical studies: a systematic review. Pediatrics. 2010;126(2):323-332.
1/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Powers SW, Kashikar-Zuck SM, et al. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA. 2013;310(24):2622-2630.
1/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Huquet A, McGrath PJ, Stinson J, Tougas ME, Doucette S. Efficacy of psychological treatment for headaches: an overview of systematic reviews and analysis of potential modifiers of treatment efficacy. Clin J Pain. 2014;30(4):353-369.
Last reviewed September 2017 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 6/5/2017
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