Recognizing migraine in your child
Migraine and migraine symptoms are different at every age. Young children, teens and adults do not all experience migraine in the same way. Also younger children and infants are not always able to express their feelings and so there are different cues for these age groups that migraine may be happening.
Infants can experience migraine. In infants, and children too young to talk, the main signs and symptoms of migraine are head-banging and irritability. Head-banging however, is common in infants and does not always mean that it is a migraine. If it is a migraine, sleep in a quiet, dark room should help the infant and resolve the issue. Diagnosing migraine in infants is very difficult and likely the diagnosis will not be clear until the child is older. 1
Instead of head pain, preschool children may instead experience the other symptoms of migraine. They may have abdominal pain, or vomit, following which they need to go to sleep. When having a migraine, preschool-aged children may look ill or pale. If they are in pain they may show it by being irritable, crying, rocking or seeking a dark room in which to sleep. 1
Children who are 5-10 years-old typically have a headache that is felt on both sides, across their forehead, around their temples, or behind their eyes. 2 When children get migraines they typically only last 1 hour, which is shorter than adult migraines, which normally last between 4-72 hours. Often when children get migraines, their migraine will wake them up or happen early in the morning, this is because sleep is a trigger for migraines, as well as being the best medicine for migraines in children. School-aged children are more likely to experience nausea, vomiting, diarrhoea or cramping in their stomachs. 3
At this age, children may express sensitivity to light, sound, touch and odour. School-aged children may also express signs and symptoms that may not classically be thought of as being related to migraine. They may complain of being thirsty, or of having a swollen feeling in their nose. Their eyes may water, and their legs and arms may appear swollen (what is referred to as edema). School-aged children may also sweat excessively when having a migraine or feel an increased need to urinate. 1
Puberty is a time of transition for migraine, especially for girls. Many girls will experience their first migraine when they begin menstruating. For both boys and girls in the pre-teen and teenage years, migraine headaches are felt more intensely and for a longer time than their childhood migraines. Teens begin to fall into the adult pattern of a headache, where the pain may last from 4-72 hours. Teenagers begin to say their headache has a pulsating or throbbing feeling. 3 And teenagers generally feel their migraines on only one side of their head, usually around their temples. Teenagers may or may not experience aura symptoms.
1. Teleanu, R. I., Vladacenco, O., Teleanu, D. M. & Epure, D. A. Treatment of Pediatric Migraine: a Review. Mædica 11, 136–143 (2016).
2. Bigal, M. E. & Lipton, R. B. Migraine at all ages. Curr. Pain Headache Rep. 10, 207–213 (2006).
3. Wilcox, S. L., Ludwick, A. M., Lebel, A. & Borsook, D. Age- and sex-related differences in the presentation of paediatric migraine: A retrospective cohort study. Cephalalgia 38, 1107–1118 (2018).