MIGRAINE IN CHILDREN/YOUNG PEOPLE

Migraine is a type of headache that can affect both children and adults, often leading to moderate to severe pain that makes a child or young person want to lie down in a quiet, dark room. While dealing with childhood neurological problems such as migraines, it's important to note that children are usually completely well in between episodes.

Roughly 1 in 10 individuals experience migraines, with prevalence reported to be about 3-10% in children and young people.

Children and young adults may experience a shorter duration of headaches, often without any preceding symptoms. It is more common for children to have headaches on both sides of the head rather than just one side. This could be linked to symptoms like a sensation of vomiting or actual episodes of vomiting.

Some children may experience aura, characterized by seeing zigzag lines or feeling tingling sensations, along with other symptoms that may precede the headache. 

In very young children, other variants may present, such as persistent vomiting, turning their neck towards one side, or abdominal pain. Additionally, some children may also report a spinning sensation or dizziness.

When you visit Dr. Rashmi Adiga,  paediatric neurologist, they’ll ask for a detailed history about the headache, including its location, duration, and associated symptoms, and perform a thorough medical and neurological examination. In most children and young people, this is usually sufficient to diagnose migraine

Doctors typically try to avoid a CT Brain scan due to radiation exposure. However, if there are atypical symptoms—such as weakness on one side of the body alongside the headache, episodes occurring several times a day, or other signs like slurred speech, double vision, or an abnormal examination—then an MRI Brain with additional sequences may be requested, based on child's symptoms.

Adequate sleep is extremely important for children. You should ensure that your child eats and drinks at regular intervals. Keeping a food diary can help identify any triggers for migraine, which can be valuable information .Additionally, exercise and stress reduction techniques will be beneficial. For some individuals, avoiding caffeine may also prove useful. Lastly, it is advisable to cut back on screen time.

You can use medicines prescribed by your doctor, apply some balm, and ask your child to sleep in a dark room.

If your child experiences headaches more than three times a month or misses school due to severe headaches, it may be time to consult a paediatric neurologist. Dr. Rashmi Adiga can discuss the various preventative medications available, which are backed by evidence-based information. These medications can help manage headaches and are especially important for children .

Many children with migraine improve as they grow older. With adequate lifestyle changes, most children can continue normal daily activities.

1. Pediatric migraine and episodic syndromes that may be associated with migraine. Daniele Spiri, Victoria Elisa Rinaldi, and Luigi Titomanlio. 

Dr Rashmi Adiga, MBBS, DCH, MRCPCH(U.K), CCT(U.K), FRCPCH, is a Consultant Paediatric Neurologist providing evidence-based information on these conditions.