Juvenile migraines

BEYOND HEADACHES

Mostly hereditary, migraine in children can severely disrupt their routine. With certain precautions and lifestyle changes, the condition can be effectively managed, says Dr Jaideep Bansal

Migraine, often thought to be affecting only adults, is appearing increasingly in kids. The disease is very common in children - about 10 percent of school-going kids suffer from it. Half of them suffer a migraine attack before they turn 12. Chances are, it is more likely to appear in boys than girls before puberty, due to change in oestrogen levels. Also, 60 percent of sufferers who had adolescent-onset migraine report ongoing migraines after the age of 30.

Migraine is a neurological disease, which manifests itself through headache and other allied symptoms like one-sided headache, nausea, vomiting, dizziness, mood changes, sensitivity to light and sound,to name a few. Among kids, it doesn’t last for as long as it does for adults, but it’s enough to disrupt a child’s normal life. Hence a doctor should be consulted as soon as it is noticed.

Looking for reasons

Chronic daily migraine is one of the most disabling types of migraine. It lasts for more than four hours in teenagers.

Inadequate sleep or disturbances in sleeping pattern can lead to migraine. To be active throughout the day, kids need to drink at least three litres of water, but this is seldom followed. Dehydration is quite common, leading to problems like severe headache. Poor eating habits as well as meals inadequate in terms of nutritional value also trigger problems like migraine quite often. Stress is not a cause of ill-health just with adults. It’s quite common among kids, too. Exam pressure, the building competition around them and many times, family problems, leads to stress and depression. Mood swings, lethargy, sleep walking and loss in appetite are the signs that parents should keep an eye out for.

Timely diagnosis

A patient’s history is the first thing that needs to be checked by a doctor. This should include factors like severity of pain, frequency, previous treatments, onset of symptoms and identifiable triggers to plan a better treatment. Migraine is generally hereditary and chances of a child getting one are higher if any of the parents has had the same problem. Tests like blood test, EEG, lumbar puncture and neuroimaging may be required to exclude other causes of headache. Sometimes, weather changes can also cause an attack; so the climate should also be taken into consideration. Sometimes, attacks in girls are associated with menstrual cycles.

Generally, there are three types of approaches followed to treat migraines. First is the acute treatment, where drugs are used to relieve the symptoms. When your child tells you that s/he is about to receive any such kind of symptom, administering appropriate dosage with the consent of healthcare professionals can be very useful. Acute therapy curtails all the symptoms before it becomes severe.

The second kind is a preventivetreatment, which helps in reducing the number of migraine attacks. Normally, if a child gets three to four attacks a month, then s/he should be referred to a doctor, because this therapy will reduce the frequency of those attacks.

The third approach is complementary treatments, where drugs are not used. In this treatment, cognitive-behavioural therapy, acupuncture, exercise, proper rest and diet help avoid attack triggers. For some children, a balanced diet, regular exercise as well as waking and going to bed at the same time every day help decrease migraine occurrences.

(The author is senior consultant, neurology at Saroj Super Speciality Hospital, Delhi)