Who gets migraines?
Migraine in children is common and becomes more common as children age. In preschool, about 3% of children will have migraines. Once children are in school that number goes up to between 4-11% of children begin getting migraines. By the time youth are in high school around 8-23% of teens will have migraines. 1 Boys, generally, are more likely to begin having migraines at a younger age than girls. Most boys will have their first migraine at around 7 years of age. Girls, alternatively, are a bit older when they first start getting migraines, at about 11 years of age. If a child experiences extra symptoms with their migraine, called aura, then they may also begin getting migraines at a younger age. 1
There are many factors that predispose someone to develop migraine. One is genetics. Migraine has been shown to run in families, 2 so if someone in the family gets migraines it is more likely that your child might get migraines also. Also after puberty females are more likely than males to get migraines. In childhood, however, boys and girls are equally as likely to get migraines. 3-5 One reason for this may be hormones. Many girls begin to have migraine when they begin to menstruate. Estrogen particularly may be to blame for migraines in girls. Estrogen is also thought to be the reason why three times as many women experience migraine as men. 6
There are some conditions that researchers and doctors believe are a variation of or a precursor to migraine. Some children or teens may have experienced one of these syndromes before getting diagnosed with migraine.
Colic – Colic is a syndrome where for the first few months of life babies cry inconsolably and are generally fussy.
Head tilting (Paroxysmal torticollis) – This is a disorder that happens in infants. Generally, the infant will tilt his or her head to one side for minutes to months. Head tilting is common in infants however and does not mean that an infant has paroxysmal torticollis. Sometimes the head tilting will happen alone and other times it will happen with other symptoms such as vomiting, irritability or the child will generally look ill. Head tilting in paroxysmal torticollis occurs regularly, but as children age, they grow out of head tilting and head tilting will usually not continue after the child turns 2-3 but certainly will not continue after 5 years of age. 7
Frequent vertigo or dizziness (Benign paroxysmal vertigo) – This is a disorder that happens in toddlers. There are brief periods of feeling dizzy or experiencing vertigo that comes and goes for no apparent reason. The dizziness is usually related to head positions and can change when the child tilts their head backwards or forwards or rolls over in bed. 8
Cyclic vomiting – In cyclic vomiting, a person will vomit for a few hours to days, generally about once or twice a month. Like migraine, there are triggers to the vomiting such as strong emotions (like being overly excited or stressed), food and hot weather. 9
Acute confusional migraine – A child who has acute confusional migraine will have chunks of time that they don’t remember. During the time that they don’t have memory of, they may have been agitated, combative, or appear to be confused and out of it. Children enter this state and then fall asleep; when they awaken they do not remember what happened. 10
Original list of conditions was adapted from review article 11
1. Lewis, D. W. Pediatric Migraine. Neurol. Clin. 27, 481–501 (2009).
2. Pelzer, N. et al. Linking migraine frequency with family history of migraine. Cephalalgia Int. J. Headache 333102418783295 (2018). doi:10.1177/0333102418783295
3. Congdon, P. J. & Forsythe, W. I. Migraine in Childhood: a Study of 300 Children. Dev. Med. Child Neurol. 21, 209–216 (1979).
4. Mazzotta, G. et al. Outcome of Juvenile Headache in Outpatients Attending 23 Italian Headache Clinics*. Headache J. Head Face Pain 39, 737–746 (1999).
5. O’Brien, H. L. & Cohen, J. M. Young Adults With Headaches: The Transition From Adolescents to Adults. Headache 55, 1404–1409 (2015).
6. Faubion, S. S., Batur, P. & Calhoun, A. H. Migraine Throughout the Female Reproductive Life Cycle. Mayo Clin. Proc. 93, 639–645 (2018).
7. Singer, H. S., Mink, J. W., Gilbert, D. L. & Jankovic, J. Chapter 6 - Transient and Developmental Movement Disorders in Children. in Movement Disorders in Childhood (Second Edition) 69–78 (Academic Press, 2016). doi:10.1016/B978-0-12-411573-6.00006-1
8. Kim, J.-S. & Zee, D. S. Benign Paroxysmal Positional Vertigo. N. Engl. J. Med. 370, 1138–1147 (2014).
9. Yang, H. R. Recent Concepts on Cyclic Vomiting Syndrome in Children. J. Neurogastroenterol. Motil. 16, 139–147 (2010).
10. Schipper, S., Riederer, F., Sándor, P. S. & Gantenbein, A. R. Acute confusional migraine: our knowledge to date. Expert Rev. Neurother. 12, 307–314 (2012).
11. Spiri, D., Rinaldi, V. E. & Titomanlio, L. Pediatric migraine and episodic syndromes that may be associated with migraine. Ital. J. Pediatr. 40, (2014).