Boone Babies Growing Up

Migraine Headaches in Children and Adolescents

The bad news: Headaches are one of the most common complaints brought to a pediatric office.

The good news: 95% of headaches are safe and can be treated.

Tension type headaches are the most common headaches in children; however, migraines are the most common type of headache that brings a patient to see their physician because they are painful and can be frequent.

Migraines are thought to be caused by a dysfunction in the neurons of the brain that makes them increasingly sensitive to a wide range of stimuli. There can be genetic and environmental causes of migraines.

Physicians can diagnose migraines by a physical exam and a thorough history. At times, other tests such as blood work or an MRI are ordered to make sure the headache is safe and there is no other underlying medical problem. Migraines occur in up to 15% of children. There are standard criteria when making a migraine diagnosis:

1. Severity of headache

2. Location of pain on the head

3. What the pain feels like

4. Other symptoms associated with the headache such as nausea and vomiting, light sensitivity, or noise sensitivity

If a diagnosis of migraine is made then a treatment plan can be addressed.

How can we prevent migraines?

Some ways to prevent migraines include drinking enough water, getting enough sleep and exercise, eating well, and having periods of relaxation daily.

• Water: Your brain cells are made up mostly of water. They get nutrients and eliminate waste through water and remain healthy through good water intake. The amount of water a child needs daily is based on their gender, activity level, and weight. Your pediatrician can help tell you how much water your child should be taking in a day. Hydrating appropriately helps prevent migraines.

• Sleep: Getting enough sleep keeps your nerve cells healthy and allows them to repair themselves. Staying up late, not sleeping enough, or staying on a computer or phone into late nighttime hours can set up conditions favorable for a migraine storm. Depending on your child’s age, they may need 8 to 12 hours of sleep.

• Exercise: Exercising at least 60 minutes a day is recommended for children, adolescents, and adults. Exercising regularly helps promote production of new blood vessels that bring nutrients to your brain, keep the nerve cells healthy, and allow nerve cells to work better in stressful situations. Exercising also produces natural endorphins which are a natural pain reliever.

• Healthy diet: Eating well is a powerful tool to prevent migraines. Keeping your glucose level consistent by eating regularly spaced-out meals can help prevent headaches. Eating breakfast is important – a good, protein-rich breakfast can especially help with headache prevention. Eating a healthy variety of foods also prevents obesity, which is a risk factor for increased headaches.

• Relaxation: Migraines can become more severe with stress. Finding time for deep breathing or relaxation throughout your day can aid in preventing migraine storms. Deep breathing and muscle relaxation techniques can be learned to help reduce stress and prevent headaches.

How do we treat migraines?

Therapy for migraines includes common over the counter medications. Ibuprofen or Naprosyn can be used up to 8 to 10 times a month on average, but are not recommended to be used more than that.

Prescription medication such as Sumatriptan can be used if the overthe-counter medications aren’t relieving the headaches. Triptans are safe and can be very effective in relieving a migraine headache. If a child has a history of migraines, they should take medicine as soon as the headache is noted to try to keep it from becoming severe.

If a headache occurs more than 4 times a month, if headaches do not respond to preventive treatments, or if headaches occur with neurological symptoms such as vision loss, visual changes or partial paralysis, it is recommended to start a preventative medication.

Common preventative medications for children and adolescents include Amitriptyline, Propranolol, Topamax and Magnesium oxide or Magnesium gluconate. If preventative medication is needed, your pediatrician can help you determine which ones are right for your child.

Meeting with your pediatrician allows your child to receive a full physical and an opportunity to explain their headache symptoms to their doctor. A migraine action plan can then be developed to give your child the opportunity to live a healthy, headache-free — or at least headache-infrequent — and happy life!

Dr. Bondurant is a pediatrician at Tiger Pediatrics. She is accepting new patients.