Migraine poses a serious problem for the tiny, tender heads

Many pediatricians and parents view migraines as an adult condition. And because many children complain of headaches more often during the school year than the summer, parents often think a child is exaggerating symptoms to get out of schoolwork.

Often the real issue, say doctors, is that changes in a child’s sleep schedule, including getting up early for school and staying up late to study, as well as skipping breakfast, not drinking enough water and weather changes can all trigger migraines when the school year starts.

Inherited condition

Migraine is an inherited neurological condition characterised by severe, often disabling headache pain. During a migraine attack, a number of changes occur throughout the brain causing dilation of blood vessels; severe pain; increased sensitivity to lights, sounds and smells; nausea and vomiting; and other symptoms. It’s estimated that about 10 per cent of young children and up to 28 per cent of older teenagers suffer from migraines.

But childhood migraine often doesn’t show up the same way as an adult migraine. While adult migraines often last four hours or more, in a child, the duration of a migraine can range from as little as one hour up to 72 hours. Complicating matters is that sometimes pediatric migraines don’t involve headache pain. Instead, the child may have abdominal pain, vomiting or feelings of vertigo.

Real and imaginary pain

Parents often have a hard time distinguishing between real pain and the imaginary maladies that young children sometimes invent.

Dr Hershey tells the story of a 6-year-old boy with daily headaches, whose parents thought he was just trying to avoid school. His parents finally sought treatment and by the time he was in the third grade the headaches were under control. “He was a different kid, more active and happy all the time,” said Dr Hershey.

Dr Hershey treats pediatric patients with a three-pronged approach. It starts with immediate pain relief, using either ibuprofen or a triptan drug. Because frequent use of over-the-counter pain relievers can set off a “rebound” effect.

Second, he says, children who have more than one headache a week may need preventive therapy. And lifestyle changes like exercise, drinking more water, getting adequate sleep and not missing meals are essential.