People of all ages experience migraines, and the symptoms in children are similar to those in adults. These can include moderate to severe headaches, nausea, vomiting, and sensitivity to light and sound.
The underlying mechanisms of migraine in children are unclear, but genetics may play a role. About half of children who experience migraines also stop having symptoms after puberty.
In this article, we describe the symptoms, causes and treatments of migraines in children.
About 3–10% of children experience migraines. The incidence increases with age until puberty, when about half of these children or young teens no longer have migraine episodes.
Alternatively, if migraine symptoms begin during adolescence, it is likely that the person will continue to experience the condition into adulthood.
Before puberty, migraines are just as likely to affect men as women. After puberty, women will be more likely to experience it.
Children with migraines experience many of the same symptoms as adults. This may include:
- a headache lasting 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 flickering lights in the field of vision that may be the first symptom
According to the National Migraine Center in the UK, children are more likely to experience pain in different places or throughout the head compared to adults.
Also, episodes in children may be shorter than in adults.
It can be difficult to diagnose migraines in young children, who may not be able to describe their symptoms. Another challenge involves the subjectivity of pain intensity – children and their parents or caregivers have little or nothing to use for comparison. For these reasons, doctors rarely diagnose migraines in children younger than 2 years.
Finally, it is noteworthy that headaches in some people with migraines are absent or a minor symptom.
Researchers do not know why some children experience migraines while others do not. However, many children with migraines have relatives with the condition, indicating that there is a genetic component.
Experts do know that certain genetic mutations expose children to some types of migraines. For example, if a child has hemiplegic migraines, a type that causes temporary weakness and paralysis, they may have a mutation in one of the following genes:
Research on the causes of other types of migraines continues.
People with migraines often find that certain foods, situations or environmental factors cause migraine episodes. Identifying these triggers can often help prevent the episodes.
However, it may take time to identify the triggers. It is also noteworthy that several triggers often overlap to contribute to the development of a migraine episode.
It may help to keep a record of a child’s migraine symptoms and any possible causes. We give specific ideas on what to record in the “Home Care” section below.
Common triggers to consider include:
- Changes in sleep patterns: A child may have an episode if they sleep too much or too little. It can help to set up and maintain a regular sleep schedule.
- Dehydration: Ensuring that a child drinks enough water, especially after physical activity, can reduce migraine symptoms.
- Food and drink: Specific foods can cause symptoms and eat too little. Notice what a child ate on days when they had symptoms, and see if that was a pattern.
- Tension: Stress and overstimulation can contribute to migraines. If a child regularly feels stressed and anxious, they may benefit from a quiet place where they can calm down. Mindfulness activities for children can also help.
- Environmental triggers: This 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 can reduce the frequency of episodes.
If a child experiences migraine symptoms, a doctor may recommend an appropriate dose of an OTC medication, such as:
However, these drugs and doses are not always suitable for children. Consult a physician or pharmacist before administering OTC medication to a child.
If a child experiences frequent or severe migraine episodes, a doctor may also prescribe a drug from a family medicine called triptans. It works 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:
- beta blockers
- amitriptyline (Elavil) or nortriptyline (Pamelor)
- antiepileptic medicine
Some children may also respond to recreational training or biofeedback.
In addition to administering medication and preventing exposure to triggers, caregivers and children can also use other strategies to treat migraine symptoms:
During an episode
If migraine symptoms occur, try:
- moves the child to a quiet, dark room
- apply cool or warm compresses on their head
- offer them an eye mask to block light if they are sensitive to light
- massage of any tense or sore muscles
- encourage the child to sleep, if it helps with their symptoms
Anyone keeping a symptom diary should take note of:
- the time and date at which the symptoms occurred
- the length and seriousness of the episode
- whether any treatments or strategies have helped
- any possible triggers
Preparation
Being prepared for migraine episodes can limit its effects. A person can:
- Make one or more migraine kits, including items such as medication, hot or cold packs, an eye mask, water, and a symptom diary.
- Read more about potential triggers and identify specifics.
- Helps identify any warning signs that symptoms are developing.
- Inform schools, day care centers and other caregivers about the child’s experiences and what to do if a migraine episode occurs.
It is worth bearing in mind that the administration of pain medication as soon as possible can help stop the progression of the migraine episode.
Emotional support
It can be difficult to determine the extent of a child’s migraine symptoms. Depending on their age, they may not understand their condition or are afraid of it.
During an episode, it is important to be reassuring and calm. After that, it may help to teach the child about the condition or have a doctor explain it to them.
Understanding what migraines are and that each episode eventually ends can alleviate some fears. It can also help the child play a proactive role in managing the condition, for example by keeping or assisting a symptom diary.
Contact a doctor about a child’s migraine symptoms. They may prescribe medication to reduce the severity and frequency of episodes. It is also important that they rule out other possible causes of the symptoms.
Some migraine symptoms resemble those of serious health problems. Seek medical emergencies if a child experiences:
- a sudden, severe headache with no other migraine symptoms
- a headache with the worst pain they have ever experienced
- a headache after a head injury
- headache and one of the following:
- a stiff neck
- confusion
- an attack
- loss of consciousness
Talk to a doctor immediately if a child has migraine symptoms:
- changes in vision, balance or coordination
- excessive vomiting
- persistent pain
- a recent change in personality or behavior
Any of the above may indicate a different underlying condition.
In children, migraines are not uncommon, and the symptoms can occur from an early age. Using OTC painkillers once the symptoms develop can stop or limit the effects. A doctor may rather prescribe migration medicine.
It is important to seek medical attention for migraine symptoms. A doctor should be sure of the cause because some symptoms look like those of other health problems.
In addition to prescribing medication, the doctor can provide guidance on identifying triggers and managing episodes.