Chronic Migraines in Children

As adults, children suffer headaches, including migraines. According to the American Family Physician, by the age of 15, about 23 percent of children have suffered migraines, with many of them experiencing chronic migraines. Early diagnosis of chronic migraines in children can start them on a lifelong treatment plan.

Symptoms

• For a diagnosis of migraine to be made, a child must have suffered at least five headache attacks. The pulsating pain can be on one or both sides of the head, as opposed to adult migraines, in which pain is usually concentrated on one side or area of the head. In addition, vomiting, nausea, abdominal pain and/or sensitivity to light and sound may be present. A child's everyday physical activities, such as playing outside, will aggravate a migraine. If a child gets migraines on 15 or more days in a month, they are considered chronic.

Diagnosis

• Your physician may conduct a battery of tests to rule out other causes for your child's headaches, such as blood tests, an MRI, a CAT scan, a spinal tap or a psychological evaluation. You can help your doctor narrow in on a diagnosis by keeping a headache diary to track the occurrence, symptoms and severity of your child's headaches. This diary can also help you track headache triggers and treatments.

Triggers and Risk Factors

• In a child's headache diary, record potential migraine triggers, such as certain foods or activities. Do not remove foods from a child's diet unless there is an obvious link between the food and migraine attacks. Limit your child's caffeine use, as both caffeine and caffeine withdrawal can cause migraines. Heredity plays a role in migraine prevalence, so a child who has relatives with migraines is more likely to have them. Children under a lot of stress or who suffer depression are also more prone to migraines.

Treatment

• A child who suffers chronic migraines should have access to migraine treatments and medications at all times, including during school. Because 90 percent of children vomit during migraine attacks, anti-emetics should be given before other medication is administered. In some cases, anti-emetics eliminate all migraine symptoms in children. Over-the-counter painkillers such as ibuprofen and acetaminophen that are formulated for children are often effective in relieving migraines, especially if taken early in the attack. Prescription migraine medications such as Imitrex have not yet been approved for children, although clinical trials have shown them safe for adolescents.

  Because overuse of painkillers can cause rebound headaches, consider supplementing with non-medication treatments, such as relaxation techniques and therapy to reduce stress. Children suffering a migraine attack should lie down in a quiet, dark room with a cold rag over their eyes or foreheads while they recover. Sleep can often eliminate migraines in children.

  About one third of children with migraines require preventative medication, according to American Family Physician. Although many preventative medications have not been tested on children, low doses of cyproheptadine, amitriptyline, propranolol, carbamazepine or valproic acid have achieved anecdotal success.

When to See a Doctor

• Seek medical advice if your child suffers headaches frequently or regularly--even once a month--if a headache follows a blow to the head or an injury or if the headache occurs with vomiting, neck pain, muscle stiffness, and/or visual changes.