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Migraine is the most common cause of disabling headache, affecting 35 million Americans. While often thought to be a condition of adults, migraine is common in children, affecting 3 percent of preschool-aged children, 4 to 11 percent of elementary school-aged children, and 8 to 23 percent of high schoolers.
Before puberty, migraine is more common in boys, while after puberty it is more common in girls. Migraine often becomes more troublesome at the onset of puberty or even a bit before the outward signs of puberty are apparent. In girls, menstrual periods can be a potent migraine trigger, particularly for the first several years of cycling.
Migraine is most often hereditary. If you have migraine, it is likely that another family member suffers from it too. However, the severity and frequency of migraine attacks can differ dramatically between family members. One family member may experience very rare migraine attacks, such as just after consuming alcohol (a "hangover headache") or with menstrual cycles, while another may have very difficult daily, debilitating migraine.
Migraine attacks are characterized by recurrent episodes of head pain that may be throbbing or pounding. The headache is accompanied by other symptoms such as nausea, vomiting and sensitivity to light and sound, as well as sensitivity to head movement. Migraine can occur at any time of day or night. In children, migraine attacks can be as short as one hour and often involve both sides of the head.
Young children may experience a form of migraine that expresses itself as regular episodes of vomiting or abdominal pain without any other sign of illness; later in childhood, the migraine headache attacks become apparent.
Signs and symptoms of migraine include:
Migraine is diagnosed based on the description of your symptoms and a neurological examination. No laboratory or imaging tests are needed to identify the condition. Your doctor will ask about the severity, frequency and duration of your headaches as well as other symptoms you experience and any medications you take.
Before meeting with a headache specialist, maintaining a headache journal that tracks headache patterns can provide helpful information for your diagnosis and treatment. Information to note in your journal includes:
If your headache is associated with visual symptoms such as flashing or zigzagging lights, blind spots or numbness on one side of the head, it is called migraine with "aura," previously known as classic or classical migraine. About 20 percent of people with migraine experience this type of headache.
Migraine attacks can be triggered by a number of factors. By identifying and avoiding these triggers, you can help manage your headaches. Keeping a headache journal that tracks the date, time of onset of your headache, a list of medications and other external factors can help you and your doctor track patterns and plan treatment.
Common trigger factors include:
Typically, over-the-counter pain relievers such as naproxen, acetaminophen and ibuprofen are recommended as initial treatments. If these do not relieve the pain, your doctor may prescribe a migraine-specific medication such as a triptan. Some triptans are FDA-approved for use in children and adolescents.
Many drugs for acute migraine attacks work best when taken as soon as you feel a migraine coming on. Your doctor will work with you to determine the treatments that are best for you, based on the severity of your attacks and whether you experience other symptoms such as nausea. Treatments, however, don't cure the condition.
If you experience frequent migraine attacks, your doctor may recommend a preventive medication to make your headaches strike less often and last for shorter periods of time.
Some medications used to treat other conditions — such as beta-blockers for high blood pressure and tricyclics for depression — are also effective in preventing migraine. The benefits and dosages of these drugs when used for migraine, however, are sometimes different than those in the treatment of other conditions.
Be sure to continue taking your preventive medications even while being treated for an acute attack.
If your doctor prescribes medication, be sure to ask:
UCSF Benioff Children's Hospitals medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child's provider.
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