Many people think of migraine as a condition that affects adults.However, migraine headaches can start at any age, affecting children as young as infants and toddlers. There are many differences between how migraines present in children and adults. What can parents do to spot a migraine and get your child relief?
What ages do migraine symptoms appear in children?
Although migraines most commonly occur in teens and young adults, migraines can start early in life and have been reported in about 3% of preschool-age children. Likewise, migraines have been reported in infants and toddlers, and some researchers believe that colic may be a sign of migraine in newborns, or at least a warning sign of migraines later in life. Migraine symptoms include nausea, vomiting and/or sensitivities to light and sound that can last for up to three days. However, these symptoms may not be as obvious or could be mistaken for other conditions when they appear in children.
How are migraines in children different?
There are many differences between how children and adults experience a migraine with or without aura. Aura is usually visual disturbances such as flashing lights, but can also be sensory, motor or verbal disturbances. Some of the most notable migraine differences in children include:
- Abdominal migraine: Abdominal migraine is a type of migraine that is mainly seen in children. Instead of complaining of headache, children will complain of a stomachache, with a dull or sore feeling, usually a cramping around the belly button. Symptoms include abdominal pain, nausea, vomiting, looking pale and loss of appetite.Many children who have abdominal migraines will develop migraine headaches later in life.
- Migraines in children may be shorter than in adults, lasting only two hours. Children often may want to sleep due to the headache. The time spent sleeping should be included as part of the duration of the migraine.
- The migraine episodes may not occur as frequently as in adults. They may happen only once a month or every few months.
- The pain tends to be across the forehead (bifrontal) rather than on just one side of the head (unilateral). As children get older, the pain usually becomes more unilateral.
- Children may not tell you they are experiencing common migraine symptoms. Parents and caregivers may have to infer from their behavior. Instead of saying they are having sensitivity to light or sound, children may ask to lie down in a quiet, dark room.
- In young children even before they complain of headache, they may get other childhood migraine syndromes. These can include:
- Abdominal migraine.
- Benign paroxysmal torticollis: This is a rare, episodic disorder that usually begins in the first 12 months of life. It usually manifests as a head tilt to one side that lasts forminutes to days. This is considered a “diagnosis of exclusion,” meaning that other conditions, like seizures, need to be ruled out.
- Benign paroxysmal vertigo: Kids can feel dizziness, a spinning sensation (vertigo), lightheadedness, unsteadiness, loss of balance, and nausea after moving their head in a certain position, such as up or down.
- Cyclic vomiting syndrome: Cyclic vomiting syndrome is a condition with intense nausea, vomiting, and feeling very tired that happens on a regular, predictable basis, usually several weeks apart. The episodes can be severe and lead to dehydration.
- There may be some connection to infant colic and migraine. Some researchers believe that colic may be an early form of migraine.
What can parents do to help their young children if they are experiencing symptoms of migraine?
It’s crucial to talk to your pediatrician about migraine symptoms your child may experience as soon as you recognize them. Getting referred to a pediatric migraine specialist can help your child get a migraine diagnosis, which can help him or her find relief from pain. Episodic headaches can morph into chronic, daily headaches if left untreated. The diagnosis of a migraine headache is based on your child’s health history. Blood tests and brain scans do not help to diagnose a migraine. Often, parents are diagnosed with migraine after their child’s diagnosis; a parent may have dismissed his or her own “sinus headaches,” when the parent was really dealing with migraines.
Migraine care at Norton Children’s
Your health care provider team may order additional tests for your child if there are features of the headache that raise concerns for a different type of headache.
Reasons to seek immediate evaluation by your pediatrician or an emergency department include:
- Thunderclap headache — a headache that is severe within a few minutes of its onset(often reported as the “worst headache of my life”)
- Positional headache — a headache that changes significantly depending on whether you are lying down or standing up
- Headache that starts after a trauma or whiplash
- Headache that wakes you from sleep at night
- Headache associated with other symptoms, such as weight loss, fever or rash
- Headache with focal neurologic symptoms, such as weakness in the arms or legs, unsteady walking, difficulty hearing or communicating, seizure, etc.
- Changes in your thinking or speech during a headache
Migraines often are underdiagnosed in children, but it is a major cause of disability that can cause kids to miss school and activities, and can affect quality of life. Many children outgrow migraines, but about a third of children will continue to experience migraines as an adult.