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Migraine is Common, but Often Misdiagnosed

Young children and teenagers commonly experience migraine, which presents differently in adults. Unlike adults, children have a more difficult time understanding and describing the severe pain caused by their migraine. As a result, children with migraine often go undiagnosed and untreated. Christina Szperka, MD, Director of the Pediatric Headache Program at the Children’s Hospitalof Philadelphia, provides an overview of common symptoms and treatment options for paediatric migraine.

Who experiences paediatric migraine?

Almost 60 percent of children complain of headache at some point, and about 8 percent of children are living with migraine. In younger children, migraine is equally common among boys and girls. However, migraine occurs more frequently in girls than in boys after puberty.

“Migraine is very common in children,” Dr. Szperka said. “We’ve learned that migraine occurs in about single-digit percentages of school aged kids. It becomes much more common through adolescence, and that migraine can be disabling.”

Children can also be diagnosed with chronic migraine, which Dr. Szperka defines as experiencing headache more than 15 days per month. “The rates are probably around 1.5 to 2 percent, depending on exactly how you define that,” Dr. Szperka said. “If you think about that, two out of every 100 children means that there are lots of teenagers out there who have very frequent headaches.”

Symptoms

Migraine symptoms vary between young children and adults. Dr. Szperka explains that some children have a more classic migraine presentation, in which pain is the predominant symptom. Younger children, however, typically have symptoms like vomiting and stomach pain, which are less common in adults. “Sometimes the child will develop severe pain and belly pain or nausea, and then vomit, and then the episode’s over,” Dr. Szperka says.

Children who present these GI symptoms tend to experience shorter migraine episodes than adults do, making them hard to treat. Even though these episodes are brief, they are still extremely painful and disrupt activities.

Additionally, while adults typically have head pain on one side of the head, children often experience pain on both sides, and their headaches are commonly accompanied by sensitivity to light and sound.

Treatment options

Parents should find comfort in knowing that migraine is common in children and adolescents, but they should also realize the severity of the pain their child could be experiencing. Seeking a diagnosis and proper treatment will make a world of difference to your child’s migraine journey. Once a general practitioner has ruled out any serious conditions, parents should work with a headache specialist to develop a treatment plan that helps their child live life without migraine.

Reprint with permission from The American Migraine Foundation 

Headache or Migraine?

A migraine involves more than just a headache. Sometimes your child will be:

• really sick, and might be sick

• extra sensitive to light and noise

• want to lie down and sleep to make it better

• uncomfortable moving about, or exercising

• more prone to car sickness

They might also feel dizzy or weak before the migraine. They might even have problems talking, or see patterns of lights or lines, this is called aura. Aura can be quite scary, especially the first time it happens. Some children with migraine don’t get a headache at all—they just get a pain in the stomach.

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