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Migraine Headache in Children and Adolescents

Do children get headaches?

Yes. About four out of five children sometimes have a headache. The most common cause is a viral infection like colds or flu. Children and adolescents can also get tension-type headaches and migraine headaches. Brain tumors can cause headaches, but these tumors are very rare. In addition to a headache, brain tumors almost always cause problems with coordination, balance, speech, sight, and walking.

What is a migraine headache?

A migraine is usually an intense pounding headache with nausea that occurs from time to time. The pounding or pulsing pain usually begins in the forehead, the side of the head, or around the eyes. The headache gradually gets worse. Just about any movement or activity seems to make it hurt more. Nausea and vomiting are common. Bright lights or loud noises make the headache worse. The headache can last for two hours or even up to two or three days.

Some people see a pattern of lines or shadows in front of their eyes as the headache is beginning. This is called a "warning aura." Most people with migraine do not have this.

Do many children get migraine headaches?

As many as 5 percent of children in grade school have migraine headaches. During the high school years, about 20 percent of adolescents get migraine headaches. These headaches are more common in girls than in boys. Boys who get migraines have them more often when they are about 10 to 12 years old. It is not unusual for them to have two to three migraine headaches a week.

How do children describe their migraine headaches?

• "It feels like my heart is pounding in my head."
• "All I want to do is throw up."
• "It is like being inside a big bass drum."
• "I just want to go into a dark room and lie down."

What causes migraine?

Migraine runs in families, so doctors think that it may be caused by an abnormal gene.

How is migraine diagnosed?

Your doctor can diagnose migraines on the basis of the symptoms your child describes. This is called the medical history. After taking the medical history, your doctor will perform a physical exam to be sure that there are no other causes for the headache.

What can help a headache?

When a migraine headache happens, your child should go to a cool, dark place and lie down with a wet cloth across his or her forehead. If the doctor has given your child a medicine for migraines, your child should take it as soon as he or she knows a headache is starting. Don't wait! If your child feels nausea, the doctor can also prescribe a medicine for that.

How can my child keep from having migraine headaches?

While there are no sure ways to keep from having migraine headaches, here are some things that may help:

• Eat regularly and do not skip meals.
• Keep a regular sleep schedule.
• Exercise regularly.
• Look for things that might trigger an attack, like certain foods, stress, too much exercise or physical activity, certain activities, or stress. Sometimes, life stresses are a trigger. Many psychologists can teach stress management and/or biofeedback to help your child manage stress.
• Look for foods that might trigger an attack, like cheese, processed meats, chocolate, caffeine, MSG (a preservative in many foods, including Asian foods), nuts, or pickles. About one third of people with migraine can identify food triggers. Your child only needs to avoid eating these foods if one of them triggers headaches.

If your child has frequent migraine headaches, your doctor may prescribe a daily preventive medicine to try to make the headaches less frequent and less severe.

Where can I get more information?

You can get more information on headaches from these groups:

This handout provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your family doctor.

Visit familydoctor.org for information on this and many other health-related topics.