Did you know, a migraine is one of the most common neurological illnesses found in children? It occurs in 10 to 15 per cent of school-going kids. The youngest child I have had come to my clinical practice was 18 months old. He presented with uncontrollable and untriggered crying bouts every week for hours.
Migraine is a health condition in which a person feels a throbbing pulsatile headache (moderate or severe intensity) on one side of the head. It can be accompanied by vomiting or nausea and extreme sensitivity to light and sound. It might last for two to 48 hours each time; an episode could occur two to four times per month.
Migraines can cause severe pain and interfere with a person's ability to conduct their daily activities. However, they rarely cause harm to the body. Migraines have no association with brain tumours or strokes.
In adults, it is easier to spot a migraine; however, when it comes to children, diagnosing the issue can be quite tricky. They are unable to describe their feelings or pain, and as migraines have a clinical history-based diagnosis, often the diagnosis is delayed.
As kids, similar numbers of boys and girls suffer from migraines; as teenagers, it is more common in girls.
What causes migraines in children?
A propensity to have migraine attacks is usually inherited. However, everyone has different triggers. Some of the common triggers in childhood are stress, certain foods, skipping meals, weather changes, hormonal changes and traumatic head injuries.
Child migraine symptoms
Symptoms of migraines differ from person to person. However, the most common ones are:
- Throbbing headache
- Mood swings
- Pale skin
- Sensitivity toward sound and light
- Appetite loss
- Vomiting or nausea
Type of migraines that can occur in kids
Before directly naming the type of migraine, it is important to understand the term ‘aura’. This is a sort of alarm to warn you that a migraine is about to set in. It might last more or less than 20 minutes.
This aura could be:
- Distorted or blurred vision
- Flashing lines or lights
- Moving lines or lights
- Blind spots
Now, let’s move toward defining the different types of migraines that could attack a child.
Migraine without an aura: Also known as a common migraine, this type affects 60 to 85 per cent of children and adolescents who get a migraine.
Migraine with an aura: This type affects 15 to 30 per cent of people. Migraine attacks in young children frequently begin in the late afternoon. As the child grows older, migraines often start in the early morning.
Ophthalmoplegic migraine: Here, eye muscle weakness or paralysis is at play. People with this sort of migraine experience pain around their eyeballs. Double vision is a common side-effect.
Hemiplegic migraine: One would feel weakness on one side of the body. US-based WebMD explains it as: “Hemiplegic migraine is a rare and serious type of migraine headache. Many of its symptoms mimic those common to stroke; for example, muscle weakness can be so extreme that it causes a temporary paralysis on one side of your body.”
Basilar migraine: This type causes tingling, numbness, pain in the base of the skull or changes in vision.
Confusional migraine: This type of migraine is more likely to occur after a minor head injury and can cause language and speech issues or confusion.
Besides these, there could be other variants that are likely to occur when a child develops migraine due to family history. These could be:
- Paroxysmal vertigo, an inner ear disorder
- Paroxysmal torticollis, which is explained by Spanish Neurology Society journal Neurologia.com, as: “…a condition characterised by recurring episodes of lateral bending of the neck, occasionally accompanied by vegetative symptoms, ataxia or an abnormal position of the trunk, with a tendency to disappear spontaneously after some months or years, and with no alterations between episodes.”
- Abdominal migraine, or recurrent episodes of moderate to severe stomach pain that lasts for between 1 and 72 hours, explains Yale Medicine.
- Cyclic vomiting, which is marked by spells of vomiting several times an hour over a period of hours or days, explains US-based Mayo Clinic.
How to treat migraines in children
Reduced noise, rest, over-the-counter painkillers, balanced meals and plenty of fluids are usually enough to treat a child's headache at home. Moreover, if your child suffers from frequent headaches and is older, specific therapies to learn to relax and manage stress may also be beneficial.
1. Pain killers
It is best to consult a doctor and get prescribed medication for your child. However, if for some reason you have to give emergency medication, an over-the-counter pain reliever can be given. With the first sign of migraine, you can give ibuprofen or paracetamol.
Keep in mind that over time pain relievers lose their effectiveness. So, you have to seek medical help and get prescribed medicine. In case of vomiting and nausea, ask a medical professional to give your child medicine to relieve nausea.
Sometimes, for frequent headaches, your doctor might prescribe ‘preventative treatments’. These are specific medications to be taken daily to reduce the frequency of these debilitating episodes.
2. Relaxation techniques
These are used to relax the body; deep breathing, progressive muscle relaxation or yoga can help. The tension is ultimately released once body muscles are relaxed. A more mature child can learn relaxation tips at home or in class with the help of videos or books.
3. Cognitive behavioural therapy
Cognitive behavioural therapy teaches your child about dealing with anxiety and reduces the occurrence and intensity of headaches. A counsellor assists your child in therapy.
4. Maintain a headache diary
By writing down the frequency, duration and intensity of the headaches, you’ll be able to identify possible triggers.
- Dr Arif Khan is a UAE-based Paediatric Neurologist and Founder of the Neuropedia clinic. Kindly note the above information is in no way meant to replace a direct consultation with a qualified medical practitioner. It is an article that can be seen as a guideline to what to look out for.