Migraine in Children by Michael B. Robbins, M.D., F.A.A.P.
In the course of our practice, we are often presented with children who
suffer from headaches. While the lay person generally equates migraine headaches
with adults, they are surprisingly common in childhood.
Some 2.5% of preschoolers and 5% of elementary school age children have
migraines. In the preschool and elementary school age group, males and females
have migraines of equal frequency. In the teenage years, migraines are more common in females. Approximately 5% of teenage males and 10% of teenage females have migraines.
Migraine headache is also called a vascular headache. This is because the pain
in migraine is believed to be due to the dilatation of blood vessels over the .
surface of the brain. In recent years, it has become clear that the primary event
in migraine involves changes in nerve cell activity, mediated by neurochemicals
in the brain.
Migraines also run in families. The key to making a diagnosis is the history.
Sometimes the child gets classical symptoms, including visual disturbances,
sensitivity to light, a pounding headache, nausea, vomiting and then a desire to
sleep. Sometimes, other symptoms occur that are not as classical, including visual
disturbances, weakness and numbness, difficulty walking, difficulty talking or
confusion. Occasionally the headaches come on for no reason at all. At other
times, they can be triggered by activities, diet, a change in sleeping pattern,
stress, and other factors. The neurological examination is important to exclude
other causes of the migraine symptoms.
Management of children�s migraine headaches involves making a diagnosis
through history and exam and any necessary diagnostic studies, looking for
triggering factors to try to prevent headaches and the use of medication. There
are medications which are effective when a child already has a headache, and
medications which can be taken every day to prevent headaches if they are
frequent or severe. Each year, new medications that are more effective and have
fewer side effects are being developed and introduced.
Disclaimer: The information and references contained
herein are intended solely for the information.
It should not be used for treatment purposes, but rather for
discussion with the patient's own physician.
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