Migraine headaches or “migraines” are a kind of headache that can happen in adults and children. Migraines often start off mild and then get worse. The symptoms of migraines are different based on the child’s age. In toddlers, symptoms include suddenly getting very pale, being less active than normal, and vomiting. In young children, migraines can cause nausea, vomiting, and belly pain, and make children sensitive to light and noise. The headache can affect the whole head or just parts of the head. For example, it might affect just the forehead or just the sides of the head. In teens, the symptoms tend to be more like the symptoms adults get. The headache usually starts off slowly and affects only one side of the head. But in about one-third of teens, both sides of the head are affected. No matter what age, most children feel better if they lie down in a quiet, dark room while they are having a migraine. Some children have something called an “aura” before a migraine starts. An aura is a weird symptom or feeling that warns the child that a migraine is coming. Each child’s aura is different, but in most cases auras affect a child’s vision. As part of an aura a child might see flashing lights, bright spots, zig-zag lines, or lose part of his or her vision. Another child might have numbness and tingling of the lips, lower face, and fingers of one hand. The aura usually lasts a few minutes and goes away when the headache starts. Some teenage girls get migraines every month, around the time their menstrual period begins. These are called “menstrual migraines.” One should seek urgent medical care if their child has a headache that; starts after a head injury, wakes him or her up from sleeping, is sudden and severe and happens with other symptoms (such as vomiting neck pain or stiffness, double vision or changes in vision, confusion, loss of balance, fever of 100.4°F (38°C) or higher. The child’s doctor can be able to tell that the child’s headaches are caused by migraine headaches by doing an exam and by learning about his or her symptoms, but once not fully convinced, he or she might request for an imaging test such as an MRI or a CT scan to rule out other causes. There are lots of prescription and non-prescription medicines that can ease the pain of migraines. There are also some medicines that can help prevent migraines from happening in the first place. The right medicine for the child will depend on how often he or she gets migraines and how severe they are. If the child gets migraines often, the parent needs to work with his or her doctor to find a treatment that helps well. If the child has headaches often, do not try to manage them on your own with non-prescription pain medicines. Giving non-prescription pain medicines too often can cause more headaches later. There are some things that can be done to reduce the chances of a child from getting a migraine more often. In some cases, migraines can be “triggered” or set off by certain foods or things that children do. Some possible headache triggers include; skipping meals, not drinking enough fluids, having too little or too much caffeine, sleeping too much or too little, stress and certain foods containing nitrates such as hot dogs. Dr. Ian Shyaka, Resident in Surgery, Rwanda Military Hospital, iangashugi@gmail.com
