Migraines In Children & Young People

Key points about migraines in children and young people 

• migraine headaches (migraines) are a type of headache often felt on one side of the head
• some tamariki and rangatahi will get an occasional migraine, others can have them often 
• although migraines can be painful and disruptive, they are not usually a serious problem
• treatment involves managing your child’s symptoms and avoiding triggers  
• migraines usually get better or go away altogether with sleep
• if your child is unwell or their headaches are ongoing or getting worse, see a doctor

What is a migraine?

A migraine is a type of headache. A migraine is often felt on one side of the head, but it can be felt on both sides. Some tamariki get migraines every now and then, while others get them more than once a week.

Migraines tend to run in the whānau (family). Around half of tamariki who get migraines will continue to have them when they are adults. For rangatahi, migraines are more frequent in females, but in tamariki, they happen equally between boys and girls.

What are the symptoms of migraine? 

Migraine symptoms in tamariki and rangatahi can be similar to migraine symptoms in adults. The symptoms often include a headache, which lasts 6 to 12 hours. 

The headache may be: 

• severe
• dull or throbbing
• felt all over the head
• felt on only one side of the head

Tamariki and rangatahi may also:

• feel sick in the stomach
• vomit
• lose their appetite 
• feel tired
• have pain in their tummy

What is a migraine aura? 

Some tamariki and rangatahi can have an aura with their migraine. An aura is a change in their vision or senses that happens just before the headache starts. 

Some examples of an aura are:

• seeing spots or zig-zag lines
• sensitivity to light, sound or smell
• tingling of the lips
• losing part of their vision

An aura usually lasts for a few minutes before disappearing when the headache begins. Tamariki may find it hard to describe what they are feeling. Often the aura can be more distressing than the headache. 

Up to 30% of migraines in children start with an aura. Migraine without an aura is more common.

What are some common triggers for migraines?

There are lots of common triggers for migraines in tamariki and rangatahi. These include:

• not drinking enough (dehydration)
• missing meals
• change in regular routine 
• stress
• lack of sleep
• bright lights, including phone, computer and TV screens 
• loud noises 
• caffeine
• smoking, or breathing in second-hand tobacco smoke 
• drinking alcohol
• using oral contraceptives (the pill)
• having a period 

What is an abdominal migraine?

Some younger tamariki experience migraines in their stomach, not their head. They often complain of pain in the middle of their tummy. This can come with some of the other symptoms of migraine, such as feeling sick and tiredness. They are well between attacks. 

Abdominal migraines may have the same triggers as migraine headaches. Rest, sleep and pain relief medicine are helpful for both migraine headaches and abdominal migraines.

If you think your child is having abdominal migraines, take them to the doctor.

Should my child with migraines see a doctor?

Rarely, headaches have a serious cause. If you are worried about your child, see a health professional. Here are some things to watch out for with your child. 

Take your child to a doctor immediately if they have:

• develops a sudden, severe headache 
• develops a headache that hurts most when they wake up, that comes with nausea or vomiting
• has a headache that keeps coming back
• repeatedly wakes up because of a headache
• has a headache that is affecting their school, home or social life 
• has a severe headache that's made worse by straining, such as when coughing, sneezing or going to the toilet

If your child has any of these symptoms with their headache, they need immediate medical attention:

• a high fever (over 38 degrees Celsius)
• seizures or fits
• confusion, drowsiness or slurred speech
• blurred vision
• unsteadiness when walking
• weakness down one side of the body
• a drooping face
• stiff neck
• a head injury, including concussion
• an unusual rash

Sometimes, tamariki can have rare migraine symptoms, including:

• feeling dizzy or fainting (called basilar migraine)
• tingling in the face and arms (hemiplegic migraine)
• suddenly becoming confused and disoriented (acute confusional migraine)

Rarely, these symptoms could be a sign of a more serious condition like a stroke. If your child has a headache and suddenly has any of these symptoms, call an ambulance (dial 111 in New Zealand) immediately.

What tests might my child with a migraine have?

Most tamariki and rangatahi with migraines won’t need tests. Your doctor can usually make a diagnosis after talking with you and your child and examining your child. This might include measuring your child’s blood pressure and looking at your child’s nerves, muscles and eyes. 

If your doctor is concerned that there is a serious cause for your child’s headache, they may refer you to a paediatrician (child health doctor). Very occasionally, your child might need a CT scan or MRI scan of their head.

See the KidsHealth page on CT scans for children for more information

See the KidsHealth page on MRI scans for children for more information

What are the treatment options for migraines?

Medicine

Migraines often respond well to simple pain relief, such as ibuprofen. If your doctor gives your child ibuprofen or you buy it at the pharmacy, follow the dosage instructions carefully. Make sure your child takes ibuprofen with food. 

Don’t take ibuprofen or other pain relief for more than 2 days in a week without advice from your doctor. It is dangerous to give more than the recommended dose. Overuse of pain medicine can cause other problems. 

Give your child pain medicine as soon as possible at the start of the headache - before it builds up and gets worse. Your doctor may prescribe specific medicines to take if your child has regular migraines.

Never give your child aspirin, as this may increase the risk of Reye syndrome, which is a rare and serious illness.

Environment

You can usually care for your child with a migraine at home. If your child can manage it, offer them fluids or a small amount of food. Encourage your child to sleep or rest in a cool, dark, quiet room.  Sleep is the best way to relieve a migraine headache. 

What things can help prevent my child from having migraines? 

Working out what triggers your child’s migraines can help you to try and avoid them.

Some things that may help reduce the chances of your child having headaches include:

• avoiding dehydration by drinking plenty of water
• regular meals, snacks and exercise
• getting plenty of good quality sleep
• having a regular routine for going to bed and getting up
• limiting screen time, especially before bed 
• avoiding caffeinated drinks like cola, coffee and energy drinks 
• managing stress 
• getting their eyes checked 

Should we keep a headache diary?

If your child is having frequent headaches, your doctor may ask you to keep a headache diary. This can help to identify certain triggers. The diary will also help your child’s doctor work out the best way to manage and treat your child’s headaches in the future.

The headache diary should include:

• when the headache started and what seemed to trigger it
• how long it lasted
• which part of the head hurt
• how bad it was on a scale of 1 (mild) to 10 (severe)
• if anything helped to soothe the headache
• any other symptoms with the headache

See the KidsHealth page on headaches to learn more about different type of headaches