Q: Do children get migraine?
A: Children, both boys and girls, can have migraine. Many adults have their first migraine attack during childhood or during adolescence. However, migraine in childhood is often not recognized and is left untreated until adulthood.
Q: Is migraine in childhood different from migraine in adulthood?
A: Migraine attacks do appear to be different in children. They are usually infrequent and of shorter duration, lasting a couple of hours or less. Children often have abdominal symptoms, known as abdominal migraine, that adults do not experience. When the more typical symptom of headache occurs, it is usually located in the forehead or middle of the head rather than being one-sided. It is rare for children to have the typical aura consisting of visual disturbance that occurs in adults; however, some do describe blurred vision and seeing spots of light or color.
Q: What are the symptoms of childhood migraine?
A: A large percentage, about 70 percent, of children have abdominal pain, sometimes together with nausea and vomiting. This symptom is known as abdominal migraine. When a headache occurs, it is usually located in the frontal area or forehead and is rare in the back of the head. The headache varies in intensity and frequently disappears with sleep. Children may also suffer from bouts of vomiting (cyclical vomiting), episodes of dizziness (benign paroxysmal vertigo), or periods of confusion (basilar artery migraine). Before a diagnosis of migraine is made, the child must be evaluated to exclude other medical problems as a cause for these symptoms.
Q: What type of childhood headache could signify a life-threatening problem?
A: It is rare for a child to awaken with a headache from migraine. The appearance of headache in the morning and headaches in the back of the head must be evaluated by a doctor to rule out other problems, such as a brain tumor. Any headache associated with fever and/or stiff neck must be evaluated to exclude meningitis.
Q: What are cyclical vomiting and abdominal migraine?
A: Children who suffer from cyclical vomiting have periodic episodes of vomiting with intense nausea but are symptom-free between attacks. Abdominal migraine is characterized by pain centered around the umbilicus (belly button), with multiple attacks in a day or a few attacks in a month. The pain may or may not be associated with nausea and vomiting. Children with abdominal migraine usually develop typical migraine during early adulthood.
Q: What is benign paroxysmal vertigo of childhood?
A: Children with this migraine syndrome have episodes of vertigo (dizziness). Between these episodes, they usually have typical migraine attacks consisting of headache. There may be a connection between episodic vertigo and motion sickness because half of all migraine sufferers have experienced motion sickness.
Q: What is basilar artery migraine?
A: The basilar artery supplies blood to parts of the brain involved in vision and balance. In basilar artery migraine, there is a disturbance in this blood flow, resulting in various symptoms. Children with this syndrome experience sudden episodes of confusion and dreamlike states. Some children have an impaired sense of time, a distorted body image, or disturbed visual perception of the environment, with visual hallucinations. The syndrome is sometimes known as the “Alice in Wonderland” syndrome.
Q: Do children with migraine need treatment?
A: Although many adults report experiencing their first migraine attack during childhood or their teenage years, doctors are reluctant to diagnosis migraine in children, particularly since the short-lasting attacks of abdominal pain can be misleading. In addition, they may be concerned that the child may be “labeled for life” as being a migraine sufferer. This view is puzzling, considering that those who care for children do not see a diagnosis of diabetes or asthma in childhood as some kind of label to be avoided. Not making a diagnosis does not make migraine go away. Instead, the child and his or her family are left trying to deal with a problem that has a significant impact on their lives.
Q: Why is it so important to correctly diagnose the cause of headache in children?
A: A headache in a child can indicate a serious underlying problem, such as a brain tumor or epilepsy, so it is particularly important that the child is evaluated promptly by a doctor. If migraine is found to be the cause of the headaches, the child deserves as aggressive a treatment program as an adult. It is not enough to tell the child and parents that “nothing is wrong” or that it is “only migraine” and send them home without treatment. Children with untreated migraine suffer from significant disability; they may have difficulty keeping up with school work and may miss out on social and family activities.
Q: Will my child “grow out” of his or her migraine?
A: Since migraine is an inherited illness, people cannot “grow out” of it. Some children, especially boys, who develop migraine during the first decade of life experience a significant reduction in the frequency of migraine attacks after puberty.
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