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Word On Children and Migraine

Our thanks to  Migraine Action (MA) for their help with this week’s feature and for the use of the support information below.

Scroll down this page for information specific to children - the MA website provides a wealth of information on this debilitating condition -for all ages- which you can access at www.migraine.org.uk

Migraine  Migraine affects up to 15% of the UK population and yet 60% of sufferers don’t consult their GP about their condition.   Migraine affects people of all ages, social classes, races and cultures.  However, it is most prevalent during the productive years (20-50) and two thirds of sufferers are women.  There may be a genetic predisposition to the condition as it often runs in families.  An attack can last from 4 hours to 72 hours, although sufferers may feel drained for a couple of days after that.  A migraine sufferer can experience an average of 13 attacks a year, but this can vary from person to person, sufferers are completely symptom-free between attacks.

It's estimated that 60% of sufferers don’t consult their GP about their migraine, electing instead to suffer in silence. There are things that can be done and new treatments are making the condition more and more manageable.  Given the complexity of the condition and that symptoms can vary from patient to patient, it’s important that you don’t give up on treatments if the first course of treatments you try don’t help. It may mean that you need a personal management plan, tailored to you, that may include some lifestyle changes alongside treatment.  Our friends at  MA can give you help and advice on this.

Symptoms (see further down this page for the differences in symptoms that present in children with migraine): If you have two or more of the following symptoms during an attack it is probable that you are suffering from migraine:

Intense throbbing headache, often on one side of the head only 
Visual disturbances (blind spots, distorted vision, flashing lights or zigzag patterns) - these symptoms are often called aura 
Nausea and/or vomiting and/or diarrhoea 
Increased sensitivity to light (photophobia)
Increased sensitivity to sounds (phonophobia)
Increased sensitivity to smells (osmophobia)

You may also experience other neurological symptoms (also known as aura), including:

stiffness of the neck and shoulders 
tingling or stiffness in the limbs 
an inability to concentrate
difficulty in speaking
paralysis or loss of consciousness (in very rare cases) 

A general rule of thumb is that if a headache and/or other associated symptoms prevent you from continuing with normal daily activities it could be a migraine.

Types of Migraine: 

Migraine without aura (common migraine)

An intense, throbbing headache, often only on one side of the head accompanied by 2 or more of the following symptoms:

nausea and 
or vomiting
photophobia (increased sensitivity to light)
phonophobia (increased sensitivity to sound)
osmophobia (increased sensitivity to smell) 
The pain is made worse by movement, and sufferers want to rest and keep still, preferably in a quiet, darkened room.
Migraine with aura (classical migraine)

In addition to the above, around 10% of sufferers also experience aura symptoms: neurological disturbances, lasting between 15 minutes and one hour before the commencement of the headache. Typically these disturbances are visual such as blind spots, flashing lights, or zigzag patterns in the vision, but can also include tingling, pins and needles or numbness in the limbs on the affected side or problems with co-ordination and articulation.

Some people experience the aura only, without the development of other symptoms or with only a mild headache.

Abdominal migraine: Often occurring in children, this form of migraine is characterised by recurrent, episodic attacks of abdominal pain lasting for several hours. The pain may be accompanied by nausea or vomiting and
or aura symptoms, but no, or very mild, headache. Often this evolves to the more common migraine pattern when the child reaches adolescence.

Hormonal migraine: Migraine in women can often be linked to hormone changes. Many women say they experienced their first migraine in the same year as their first menstrual period. Most female sufferers are more susceptible to an attack around the time of their period but true menstrual migraine is defined as occurring within two days either side of the first day of a monthly period and at no other time. Hormonal factors are one of many triggers for migraine and attacks may be prevented if other triggers are avoided around the time of their period.

Other rare forms of migraine: Hemiplegic migraine: this is a very rare condition which has been linked to a genetic abnormality. Symptoms include temporary paralysis down one side of the body, which can last for several days. Other symptoms include vertigo or difficulty walking, double vision or blindness, hearing impairment, numbness around the mouth leading to trouble speaking or swallowing. This form of migraine may be confused with a stroke, but the effects are usually fully reversible.

Basilar artery migraine: in some cases during a migraine attack, the basilar artery, a blood vessel at the base of the brain, goes into spasm causing a diminished blood supply to parts of the brain. This can cause giddiness, double vision, unsteadiness, fainting or even loss of consciousness.

Ocular / Opthalmoplegic migraine: another rare form of migraine with lateralised pain (often around the eye), accompanied by nausea, vomiting and double vision.

Cluster migraine: this is a misnomer, which is sometimes incorrectly applied when sufferers experience frequent migraine attacks over a short space of time.

Migraine in Children Children and even babies can suffer from migraine.

Sometimes in young children the predominant symptoms are abdominal pain often accompanied by nausea and vomiting and it is only the regular intermittent pattern of the attacks, sometimes coupled with a family history of migraine that suggest the diagnosis.

When the more typical migraine symptom of headache occurs in children they will often report it in the forehead or the middle of the head rather than on one side

Children may also experience symptoms including pallor, sometimes with dark rings around the eyes, dizziness, confusion, lack of co-ordination or occasionally non-specific aches and pains in the limbs. Children with migraine often have a tendency to travel sickness.

Attacks in children are usually shorter than in adults, perhaps around 1-2 hours. During a migraine a child will usually want to sit or lie quietly and may refuse food. A child who complains of headache and then runs off to play does not have migraine.

It is useful to keep a migraine diary to try to establish any pattern to the attacks. Dramatic improvement can be achieved by the avoidance of trigger factors. One of the most common trigger factors in children is lack of food or long gaps between food and attacks can often be eliminated completely by eating small regular meals containing slow release carbohydrate; migraine precipitated by a long overnight fast can often be overcome with a snack at bedtime (e.g. a bowl of cereal) and a substantial breakfast.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.