Migraine headaches are very common in children.  About 5% of elementary school-aged children and 15% of high school adolescents experience migraine headaches.

Migraine attacks last one to 12 hours and are intense and pounding, often causing nausea and pain across the forehead or sides of the head.  During an episode the child often will withdraw to a quiet, dark place to rest since light and sound aggravate the pain.  Usually, the child will look pale and have no appetite. The child may not even mention a headache, but complain about abdominal pain, dizziness, diarrhea, or sweating.

Most children will have only one or two migraine attacks per month, but some, particularly ten to fourteen-year old boys, may have up to two or three per week.

The exact cause of migraine is still unknown. Since children suffering with migraines frequently have family members also suffering from intense headache attacks, many scientists believe there is an inherited predisposition for migraines.

The first step of treatment is accurate diagnosis and to rule out other possible causes of headache.  The child’s pediatrician can determine this with a thorough medical history and physical examination.

The next step is to establish the pattern of the child’s headaches by keeping a headache diary.   This should include when headaches occur, how long they last, what the child was doing when the headaches start, what he had eaten, how much sleep he had, and what seems to make the headaches better or worse.

The best treatment is the prompt use of pain medicine, within 30 minutes of the onset of the pain.   Since the headaches often start at school, the medicine must be available to the student at school for prompt administration to prevent escalation of the pain.

Research shows that over-the-counter medicines ibuprofen and acetaminophen were the best medicines for children less than 12 years old.  If the migraines are very frequent, or are interfering with school, the pediatrician may prescribe a daily medication to help prevent the migraine.

Simple lifestyle modifications also can help prevent migraines. Children should not skip meals and get plenty of rest.  Parents can help the child search for triggers (stress, foods, activities) and learn to avoid them. Learning to “unwind” may be one of the most important points in preventing attacks. Children with migraines should not try to push their activities since tension and stress often trigger attacks.

If your child is suffering from frequent headaches, see your pediatrician and ask about these pediatric migraine treatment guidelines.