If you’ve experienced a migraine headache before, the sensation is often very distinct: throbbing pain, sensitivity to light and loud noise, and sometimes nausea and vomiting. Migraine symptoms can be uncomfortable and distressing.
Equally concerning is when a migraine sufferer recognizes these symptoms in their child. Migraines typically emerge during early adolescence, particularly when females reach menarche (their first menstrual period). However, as many as half of the children can experience a migraine before the age of 12. Parents often wonder if this means their child will inevitably miss school days and if they will undergo the same headaches.
Migraine headaches can be just as real for children as they are for adults. “You have more than a 60 percent chance of developing migraines if one of your parents has a history of migraines,” says Dr. Bradley Torphy, Managing Director of the Chicago Headache Center and Research Institute (CHCRI). “If both parents are affected, the risk is more than 80 percent.”
For parents who haven’t experienced migraines, the presenting symptoms can sometimes resemble a stomach bug or a more severe neurological disease. Children frequently complain of nausea and vomiting as one of the most common and limiting features of their migraines. Uncontrolled, it can force them to miss school and activities regularly.
At the CHCRI, parents of children with migraines are advised to maintain a diligent symptom diary to identify potential trigger foods and behaviors. Ensuring adequate sleep and developing coping mechanisms for stress are crucial first steps in controlling migraines. Just like adults, children with migraines often benefit from resting in a quiet, dark room at the onset of symptoms. However, this may not always be immediately feasible. The pain of a migraine headache is genuine and warrants a visit to a doctor to discuss treatment strategies better suited for a busy schedule and active lifestyle.
When over-the-counter ibuprofen proves insufficient in relieving the headache or is required multiple times in a month, it may be time to consider prophylactic medication to prevent frequent migraines. Dr. Torphy offers adolescents solutions similar to those provided for his adult patients. “There are drug options initially prescribed as blood pressure medications and antidepressants that have been shown to significantly decrease the number of migraine headache days.” Additionally, migraine prophylaxis can help prevent “rebound headaches,” which can occur when a patient excessively uses ibuprofen or acetaminophen over time. Repetitive use of these over-the-counter medications can potentially trigger a headache.
Fortunately, significant progress has been made in both abortive and prophylactic migraine headache medications. In recent years, several oral medications have been developed to target the calcitonin gene-related peptide (CGRP) pathway, which has been linked to the severity and frequency of migraines. CGRP inhibitors have shown promising data in relieving symptoms when traditional medications fail. Adult migraine patients may not be aware of these newer options, and an evaluation with a doctor can help determine the right choice.
Christopher Medrano is a family medicine resident.