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Headaches and Migraines

Summary

Migraines are a common cause of headaches in children, affecting about 10% of kids. These headaches can be severe and may impact daily activities, including school and play. Migraines can sometimes improve as a child grows, with up to half of affected children experiencing fewer or no migraines over time.

Not all migraine treatments work for every child, and psychological factors such as stress and anxiety may influence symptoms. A doctor will consider other possible causes of headaches before diagnosing a migraine.

Diagnosis and When to Seek Help

A child may have a migraine if they experience:

  • Moderate to severe headaches that last between 2 and 48 hours.
  • Pain that is throbbing, worsens with movement, or is located on one or both sides of the head.
  • Sensitivity to light (photophobia) or sound (phonophobia).
  • Nausea or vomiting.

Seek medical attention if your child experiences:

  • Sudden, severe headaches that are different from their usual migraines.
  • Headaches with fever, neck stiffness, confusion, or vision changes.
  • Headaches that wake them from sleep or worsen over time.

Management

Migraine treatment is personalized and may include:

Acute Treatment (for immediate relief):

  • Rest in a quiet, dark room to reduce symptoms.
  • Pain relievers such as ibuprofen or acetaminophen, taken early in the headache.
  • Hydration—ensuring the child drinks enough fluids.

Preventive Strategies:

  • Avoiding triggers such as stress, poor sleep, dehydration, or certain foods.
  • Establishing a regular sleep schedule and maintaining a balanced diet.
  • Stress management techniques like relaxation exercises or counseling.
  • Medications may be considered if migraines are frequent or severe.

Follow-Up and Monitoring

  • Keep a headache diary to track patterns, triggers, and treatment effectiveness.
  • Follow up with a doctor to adjust treatment if needed.
  • Encourage healthy habits to help reduce the frequency of migraines.

With the right approach, migraines can be managed, allowing children to stay active and engaged in daily life.

headaches and migraines

History and Exam

Key diagnostic factor

  • presence of risk factors
  • age >2 years
  • gradual onset of headache
  • normal physical examination

Other diagnostic factors

  • aura
  • nausea and/or vomiting
  • visual disturbance
  • phonophobia

Risk factors

  • positive family history of migraine
  • chocolate, cheese, and citrus fruits
  • stress
  • hormonal changes

Diagnostic Investigations

1st investigations to order

  • no initial test

Investigations to consider

  • brain CT/MRI

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 Address