Treating Migraines In Children And Adolescents
Treatment for childhood and adolescent migraines depends on the age of the child and the frequency and severity of the attacks. Expert help from headache doctors or centers specializing in migraines may be required for children who are difficult to diagnosis or who dont respond to initial treatment and prevention measures. Migraine treatment can include:
- SleepMany children recover well with deep sleep.
- Over-the-counter productsfor mild to moderate migraines, general pain medications like acetaminophen, ibuprofen and naproxen sodium used early in the course of the headache are often effective.
- Drugs that treat nausea and vomitingMigraines can include loss of appetite, abdominal pain and vomiting, so anti-nausea drugs can be very helpful.
NOTE: If your child is taking medication for headaches more than twice per week, contact their doctor as soon as possible.
Migraine Is Disabling In Kids And Teens Too
While symptoms of migraine in kids and teens may be different from those typically found in adults, children can be just as disabled. In addition to the attack-related disability itself, kids and teens may develop anticipatory anxiety, worrying that at any time an attack could disrupt their life. Its quite common for kids who suffer to be absent from school and unable to participate in after-school and weekend activities. In fact, kids who have migraine are absent from school twice as often as kids who dont.
Kids and especially adolescents and teens can also suffer from one of the most disabling types of migraine, chronic migraine . CM occurs when a child has 15 or more headache days per month lasting more than 4 hours, for more than 3 months. Many teenagers with CM report daily headaches. Head pain isnt the only symptom of CM other common symptoms include dizziness, sleep disturbances, anxiety, depression, difficulty concentrating, and fatigue. CM is challenging to treat and significantly impairs quality of life.
How Are Migraines Diagnosed
Your doctor will ask a lot of questions to see what might be causing the symptoms, and will examine you, paying particular attention to the neurological exam. He or she may ask you to keep a headache diary to help figure out what triggers your headaches. The information you record will help the doctor figure out the best treatment.
Sometimes, doctors may order blood tests or imaging tests, such as a CAT scan or MRI of the brain, to rule out medical problems that might cause a person’s migraines.
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Relieving Headaches In Children
As soon as your child complains of a headache, there are some steps you can take at home to help reduce the pain and associated symptoms.
- Make sure theyre hydrated, well-rested, and eating a balanced diet treating an occasional headache can be as simple as giving your child something to eat and drink, and time to lie down and rest.iii To help prevent headaches in the future, ensure your child has a balanced diet that means plenty of fruits and vegetables, lean meats and dairy products and limit processed foods that are high in fats and sugars.iii;
- Use a cool compress ;applying a moist, cool cloth on their forehead may provide some relief.iii You could also massage their head and neck muscles.iii
- Use age-appropriate over-the-counter pain relief ;if you think your child needs pain relief,;you can administer some non-prescription pain medicine to help manage their headache symptoms.iii Paracetamol such as Childrens Panadol Colour-Free Suspension 1-5 Years and Childens Panadol Elixir 5-12 Years are appropriate for younger children. Childrens Panadol Colour-Free Baby Drops 1 month – 2 Years is suitable for children from 1 month old and is available in liquid form.
If your child is suffering an increasing number of headaches, keep a diary of when they happen and how long they last, and try to pinpoint any triggers, such as foods, sleep deprivation, stress, exercise or dehydration.iii That way youll have a more detailed history to discuss with your doctor.iii
Are There Other Types Of Migraine That Occur In Children And Adolescents
Yes, other types are grouped as either complicated migraine or migraine variants.
Complicated migraines are migraines with neurological symptoms, including:
- Paralysis or weakness of the eye muscles that keep the eye in its normal position and control its movement. This was previously called an ophthalmoplegic migraine.
- Weakness on one side of the body. This is called a hemiplegic migraine.
- Pain at the base of the skull as well as numbness, tingling, visual changes and balance difficulties . This is called basilar migraine.
- Confusion and speech and language problems. This is called confusional migraine and may also occur after a minor head injury.
- Migraine variants are disorders in which the symptoms appear and disappear from time to time. Headache pain may be absent. Migraine variants are more common in children who have a family history of migraine or who will develop migraine later in life. Migraine variants include:
- Paroxysmal vertigo dizziness and vertigo that is brief, sudden, intense, and recurs.
- Paroxysmal torticollis sudden contraction of the neck muscles on one side of the head that causes the head to tilt to one side.
- Cyclic vomiting uncontrolled vomiting that lasts about 24 hours and occurs every 60 to 90 days.
- Abdominal migraine pain in the belly, usually near the belly button . Pain usually lasts 1 to 2 hours.
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What Headache Symptoms In Children Should Parents Look For
A lot depends on your child’s age and their ability to communicate with you. Children as young as infants can experience headaches.
The way they express their pain is different depending on their age. Babies who can’t speak yet may cry, touch their heads or tightly close their eyes to avoid painful stimuli. Toddlers or elementary-age children may say their head hurts, bright lights are bothering them or use visual imagery to express their level of pain. Teens may become moody or withdrawn. Children experiencing headaches may report pain in the front of their head, or all over their head. Headaches in children may occur repeatedly, be provoked by something or occur out of the blue.
The Most Common Symptoms Of Cluster Headaches Tension Headaches And Migraines:
- Throbbing or pounding head pain. May or may not worsen with exertion.
- Nausea and/or vomiting.
- Stomach ache.
- Extreme sensitivity to light and sound.
- Pressing tightness in the head or neck muscles.
- Sharp, stabbing pain on one or both sides of the head.
- Pain accompanied by teariness, congestion, runny nose, restlessness/agitation.
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How Is Abdominal Migraine Similar To A Migraine
Abdominal migraine and migraine share similar triggers, such as stress, skipping meals, exposure to bright light, poor sleep, and foods containing chocolate, caffeine, and monosodium glutamate . Because there are so few studies on medications used to treat abdominal migraine, patients with the condition are often treated with medications shown to be effective on a migraine.;
More Headache Types And Associated Diseases And Conditions
- Acephalic migraine of childhood : This condition is characterized by a migraine aura without headache. Females are more likely than males to have this type of migraine.
- Alice in Wonderland Syndrome: The syndrome is characterized by headache that is preceded by visual hallucinations or delusions, distortions of body image and abnormalities in the experience of time. Such experiences may wax and wane over several days to months, and children generally recover without residual problems. It is most commonly seen in the young school-aged child.
- Menstrual migraine: Menstrual migraine occurs in close approximation to the onset of menstruation and will commonly last for 2 to 3 days. The cause of such migraine headaches has been postulated to be associated with the reduction of estrogen and progesterone levels that are associated with menses. No aura is appreciated with menstrual migraines. Women who suffer from menstrual migraines may also experience more traditional migraines at other times of their menstrual cycle.
Associated diseases and conditions
- Many migraineurs report anxiety or sadness.
- Whether the headache or the mood or anxiety symptoms appear first is unclear.
- Epilepsy and migraine headaches often occur in the same person and may be related.
- About 70% of individuals with partial complex seizures have migraines, but most people with migraines do not have seizures.
Miscellaneous migraine facts
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Signs And Symptoms Of Migraines
Migraines are often undiagnosed in children and adolescents. In children, the symptoms may include unexplained nausea and vomiting, abdominal pain or dizziness. Some children may experience what is called aura. Aura is a visual disturbance which usually happens after a headache. This is called a classic migraine.
Signs and symptoms of aura include:
- Dizziness, vertigo, faint feelings or fainting
- Numbness or tingling, mostly on one side of body
- Visual changes, blurring, seeing spots, lines or zigzags, blind spots and rainbows around objects
- On rare occasions, confusion, hallucinations, weakness on one side of the body and inability to speak
Before a migraine happens, you can observe changes in your childs behavior. These changes are
- Food craving
- Withdrawn attitude
Sensitivity to light, touch or smell is common as well. Motion sickness should not be ignored because this is an early warning of the predisposition to childhood migraines.
Who Is At Risk For Abdominal Migraine
Abdominal migraines mostly affect children, with the first episode occurring between 3 and 10 years old. Most children seem to outgrow the condition, though abdominal migraines in adulthood are just starting to be studied. A child with a family or personal history of migraine headache has an increased chance of developing abdominal migraine.;
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How Are Migraines Treated
Migraine headaches and their triggers can vary a lot between people. Treatment can depend on how severe the headaches are, how often they happen, and what symptoms a person gets with them.
Usually it helps to lie down in a cool, dark, quiet room. Your doctor may prescribe pain relief medicine or medicines that help with nausea and vomiting. Some people need preventive medicines that are taken every day to reduce the number and severity of the migraines.
Some doctors teach a technique called biofeedback to their patients with migraines. This helps a person learn to relax and use the brain to gain control over certain body functions that cause tension and pain. If a migraine begins slowly, some people can use biofeedback to remain calm and stop the attack.
Adding other non-medicine therapies to the treatment plan, such as acupuncture or herbs, helps some people with migraines. But ask your health care provider about these before trying them. This is especially true of herbal treatments because they can affect how other medicines work.
How Are Headaches Treated In Children And Adolescents
The proper treatment will depend on several factors, including the type and frequency of the headache, its cause, and the age of the child. Treatment may include headache education, lifestyle changes, stress management, and medications.
Headache education. Patient education includes learning about your headache type and recording what triggers the headaches, such as lack of sleep, specific foods and beverages, or stress. Common food and beverage triggers include caffeinated foods and beverages , chocolate, nitrates/nitrites , aged cheeses , and monosodium glutamate -containing foods .
Your doctor may give you a headache diary to record your headache experiences. After reviewing your diary, your doctor will recommend ways to manage your headache triggers. Bring this diary with you to all of your appointments.
Lifestyle changes. Many headaches are related to poor lifestyle habits. Important basics to headache management are to get 8 hours of sleep a night, drink six 8-oz glasses of water day, eat three healthy meals a day , limit the use of over-the-counter medications 2 days/week or less, and get cardio exercise .
Relaxation techniques. Learning relaxation techniques can help reduce the pain and/or frequency of the headaches. If you have a headache, you should:
Other ways to relax or reduce stress include:
- Deep breathing exercises
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Headaches In Children And Adolescents
Children with headache are brought to medical attention by their parents primarily for reassurance that the;headaches are not a sign of a brain tumor or serious illness. A thorough history, physical, and when appropriate, diagnostic testing will enable the practitioner to distinguish primary headaches form these of a secondary etiology. The less common primary headache syndromes as well as secondary headache disorders, can prove to be quite anxiety provoking not only to the patient and their parents; but also to the practitioner both to the degree to which the evaluation should be taken as well as appropriate therapy to be recommended.
The evaluation of the child, especially under the age of ten, requires creative techniques as well as input from the parents in order to obtain a complete history. It is important to determine whether there is more than; one type of headache experience by the child. How many days missed from school can help determine the frequency, severity, and disability.
When Will 12 To 15 Year Olds Get The Covid Vaccine
The NHS will offer the vaccine by Monday August 23 to eligible children between 12 and 15 years old.
They only intend to offer the jab to children in this age group who are at risk from the virus. This includes children who have:
- A severe neurodisability
On announcing plans to offer the jab to those with underlying health conditions under the age of 15, Vaccines Minister Nadim Zahawi said, I know that people will have questions about what it means for them and their children, but I can assure them that nobody needs to come forward at this stage the NHS will get in touch with them at the right time and they will make sure that the jabs are delivered in a setting that meets their complex needs.
While Health Secretary Sajid Javid confirmed that he had asked the NHS to prepare vaccinations for eligible children as soon as possible.
He added, Our independent medicines regulator, the Medicines and Healthcare products Regulatory Agency, has approved the Pfizer/BioNTech vaccine for people aged 12 and over as it meets their robust standards of safety, effectiveness and quality.
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How Does Migraine Affect Teenagers
Migraine headaches can impact school performance and attendance, social and family interactions, and quality of life in general, says Eric Bastings, MD, deputy director of the Division of Neurology Products in the U. S. Food and Drug Administrations Center for Drug Evaluation and Research.
According to the Migraine Research Foundation, up to 10 percent of school-aged children have migraine. By the time they turn 17, up to 8 percent of boys and 23 percent of girls have experienced a migraine headache.
Its important that people realize that children and adolescents have migraine, says Amy Gelfand, MD, a pediatric neurologist at the University of California San Francisco Headache Center. Its one of the more common problems for children.
She continues, Theres a lot of stigma around children and migraine. People think theyre faking, but for some children and adolescents it can be quite a disabling problem.
In adolescents, migraine affects young women more than young men. This may be because of a change in estrogen levels.
It is fairly common for migraine to begin in puberty, Gelfand says. A migraine can be activated any time theres a lot of change going on.
Eileen Donovan-Kranz says that her daughter had her first migraine attack when she was in eighth grade. She says her daughter spent much of her time after school lying down in her room.
Her daughter is now 20 years old. Although her migraine attacks have decreased in frequency, they still occur.
Returning To Classrooms And To Severe Headaches
For kids around the country its back-to-school time. But for many of them, its also the return of headache season.
Doctors say frequent headaches and migraines are among the most common childhood health complaints, yet the problem gets surprisingly little attention from the medical community. Many pediatricians and parents view migraines as an adult condition. And because many children complain of headaches more often during the school year than the summer, parents often think a child is exaggerating symptoms to get out of schoolwork.
Often the real issue, say doctors, is that changes in a childs sleep schedule, including getting up early for school and staying up late to study, as well as skipping breakfast, not drinking enough water and weather changes can all trigger migraines when the school year starts.
In many areas people just dont think kids can get migraines, says Dr. Andrew Hershey, professor of pediatrics and neurology and director of the headache center at Cincinnati Childrens Hospital Medical Center. But kids shouldnt be missing activities and having trouble at school because theyre having headaches. If it happens, it shouldnt be ignored.
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The Headache Clinic At Great Ormond Street Hospital
There is a headache clinic at GOSH, which aims to help children and young people when the diagnosis of headache is not certain and treatment has failed. Referrals need to be made by your local paediatrician to Dr Prabhakar Consultant in Paediatric Neurology. We encourage family doctors to make referrals via their local paediatric team.
Migraine Headache In Children More Medical Treatment
An estimated 20% to 50% of migraineurs are sensitive to foods. These dietary triggers are thought to cause a change that provokes a migraine attack. Helping children learn to recognize and avoid these triggers is helpful but often difficult. The following are some common dietary triggers:
Both OTC and prescription medications can trigger or worsen migraine headaches. Cimetidine , estrogen , histamine, hydralazine , nifedipine , nitroglycerin , ranitidine , and reserpine are examples of medications that can increase migraine frequency.
Excessive use of OTC pain medications and analgesics can cause occasional migraine attacks to convert to analgesic-abuse headaches or drug-induced headaches that do not respond to treatment. Children with migraines should avoid frequent or long-term use of NSAIDs, acetaminophen, triptans, or ergotamines. Migraineurs who have been treated for a long time with amphetamines , phenothiazine , or propranolol should avoid sudden withdrawal from these medications because migraine headaches may result.
In children who have an inborn tendency for migraine headaches, attacks can occur as a result of psychological , physiological , or environmental triggers. Physical exertion and travel or motion can be triggers.
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