Headaches / Migraines (Pediatric)

What are pediatric migraines?

Pediatric migraines are throbbing headaches often accompanied by nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual disturbances.

Changes in blood flow to the brain may contribute to the onset. However, chemical compounds and hormones, such as serotonin and estrogen, often play a role in pain sensitivity.

Migraine headaches are just as disabling for children and teens as they are for adults, though episodes are usually shorter.

Migraines also have distinct stages—though not every patient experiences all of them.

• Premonition phase is marked by a change in mood or behavior hours or days before the headache starts.
• Aura phase is when a number of visual, sensory, or motor symptoms occur just before the headache. A child may experience hallucinations, numbness, changes in speech, and muscle weakness.
• Headache phase is when achild feels throbbing pain on one or both sides of the head. The pain may be accompanied by sensitivity to light and movement along with fatigue, depression, and anxiety.
• Headache resolution phase is when pain lessens, but the attack is followed by exhaustion, irritability, and difficulty with concentration, though some patients feel refreshed afterward.

Migraine headaches occur with or without the aura.

How are pediatric migraines diagnosed?

To help us make an accurate diagnosis, track information about the headaches and share it with your child's doctor. Answer these questions:

• What is the time of day when your child’s headaches occur?
• What is the specific location of the headaches (ask the child where it hurts)?
• How do the headaches make your child feel?
• How long do the headaches last?
• Does your child have any changes in behavior or personality?
• Is the headache affected by any change in position or activities?
• Does the headache affect your child’s sleep patterns?
• Is there any unusual stress in your child’s life?
• Has your child suffered from a head trauma?

After a medical history and physical examination, we may order any of the following diagnostic tests to rule out other problems, such as tumors, infection, or blood vessel irregularities.

• Computed tomography scan (CT or CAT scan) shows “slices” of the anatomy, using a combination of X-rays and computer technology. CT scans provide more information than general X-rays.
• Magnetic resonance imaging (MRI) scan uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and anatomical structures.
• Lumbar puncture (spinal tap) uses a needle placed in your child’s lower back to measure the pressure in the spinal canal and brain. During this procedure, a small amount of cerebral spinal fluid (CSF) is removed and then sent to a lab for analysis.

What is the treatment for pediatric migraines?

We design a treatment plan for each child based on the nature of the headache. Treatment may include:

• avoiding known triggers, such as certain foods and beverages
• changing eating habits
• exercise
• fasting
• getting enough sleep
• medication to prevent headaches, to halt one once in progress, and to reduce its effects
• rest in a quiet, dark environment
• stress management

Some headaches require immediate medical attention, including hospitalization. Treatment is customized depending on the severity and frequency of symptoms.