Migraine Information for Children and Teenagers
A migraine does not feel like an ordinary headache: your head hurts a lot and it can make you feel very ill. If it feels worse when you move and you cannot bear the light or noise, then you probably have a migraine. You might still get other kinds of headaches that are not as bad too.
If you have a migraine just once in a while, it can be quite unpleasant already. But if you get it a lot, then this can make you feel generally unwell. You are not alone, however. Many young people get migraines that are so bad that they simply cannot go out. They end up missing out on school and some of the things that their friends are doing at that time. What many people do not know is that about 1 in every 10 teenagers sometimes has migraines.
The good news is that there is a lot that you can do to reduce your migraines and manage them when you do have them. There is a very good chance that the migraines will even go away completely as you get older. Here you can read about how you can look after yourself so that you do not get migraines as often, as well as how you can handle them best when they hit.
The Difference Between a Migraine and an Ordinary Headache
There are several types of headache. If you are getting bad headaches, your doctor will examine you to make sure that there is not something else causing them. Sometimes, for example, a problem with the joints in the jaw causes headaches. Or you might get headaches because you are taking too many tablets, which cause headaches themselves. So the doctor will want to check that everything else is okay with you before he or she can be sure that an actual migraine is the main problem. Migraines are not caused by another health problem.
Ordinary headaches are mostly tension headaches. Most of us get these and you might know what they are like, too. You feel pressure inside your head and it is really tight. With this kind of headache, the pain goes all the way through your head. It can happen when you are under a lot of stress or if you have not had enough sleep.
A migraine is different. Some people get what is called an “aura” before a migraine starts. If that happens, they may see lights or things might start to get blurry, or look wavy or wobbly. But some people who have migraines do not get auras at all.
These are other tell-tale signs that you have a migraine:
There is bad throbbing or pounding pain – especially at the front of your head.
It is usually one-sided: only one side of your head hurts, and it is not always the same side.
The headache lasts longer: from a couple of hours up to three days.
Moving around makes your headache worse.
Light and noise really bother you or are even unbearable.
You feel nauseous or queasy, and sometimes you might even throw up. A migraine might also cause a stomach ache as well.
If the pain is so bad that you really need to lie down somewhere dark and quiet, and this has happened a few times, then it may be a migraine.
Causes of Migraines
You might already know quite a lot about migraines if other people in your family get them too. Migraines run in the families of over half of the people who get migraines.
Researchers are still not sure about exactly what causes migraines. An allergic reaction could be involved sometimes. Or perhaps your body is not getting enough of a certain substance, like a vitamin, for example, and this might be partly to blame. Stress is often an important factor when it comes to pain: being nervous or tense can make pain worse or more likely to happen at all. Having very hectic days without enough breaks in them may also make headaches more likely.
Once girls start having their periods (menstruation), the hormones from their menstrual cycle can cause migraines. Because of this, from puberty onwards, more girls have migraines than boys.
For both children and adults, irregular sleep and eating habits can make migraines more likely if you are prone to having them anyway. Many experts also believe that there is a link between migraines, diet and physical exercise, but researchers cannot say for sure whether these assumptions are really true or not.
Something that sets a migraine off, like something you eat or something you do, is called a “trigger”. But it is important not to jump to conclusions about what is triggering your migraines: it is better to try to make sure there really is a link before you make big changes in your diet or stop doing certain activities. Making sure you have a good and balanced diet is particularly important while you are still growing.
Some of the things you can look out for because they are thought to be triggers for migraines include:
cheese and milk
food additives (chemicals that are added to certain food products), like the sweetener called aspartame and flavor enhancers called glutamates
The best known way to find out what is triggering your migraines: Keep a diary about your migraines and headaches for a few weeks or months. In a headache or migraine diary you write down
what was happening on the days you got a migraine,
when the migraine started and when it was over,
how bad the migraine was, and
whether you took any medication – and if so, what and how much?
Then if you think that something in particular is causing your migraine – eating chocolate, for example – you also start keeping track of what happens whenever you eat chocolate. It is a bit like doing a science experiment in school, because before you decide to never eat cheese or chocolate again, or never drink cola again, for example, you might want to be sure that it was not just a coincidence that you had a migraine after eating chocolate.
If you do cut something out, and your migraines are just as bad and come just as often, you can write that in your diary too. Just relying on your memory can be risky because, for example, you might not remember all the times you ate chocolate without having a migraine.
How to Prevent Migraines
If you are sure that something is triggering your migraines, and you can avoid that trigger, you might be able to prevent some of your migraines – or they could be less painful or be over more quickly.
Getting good sleep regularly can also help. Some things that could be keeping you from sleeping well enough and long enough at night include
too much excitement just before bedtime – like listening to loud music,
having long phone conversations with friends,
reading something exciting or watching television at bedtime, or
drinking anything with caffeine in it, like cola, tea or coffee.
To get a better night’s sleep it may also help to do these things:
go to bed at the same time every night
keep your bedroom at a comfortable room temperature (not too hot or too cold)
learn how to relax your body and mind
It has also been proven that relaxation can also help children and teenagers to have less painful migraines. To learn how to relax, you might get training in certain techniques that can help you manage stress and muscle tension better. Your doctor and parents could help you find someone who can teach you these kinds of techniques. This is one of the best proven ways to reduce migraines.
Medicines or Vitamins that can Prevent Migraines
Some people take dietary supplements or herbal products to try to prevent their migraines. None of these have been proven to work in children or teenagers. There are some medications that have been proven to prevent migraines in adults. But young people’s migraines are a bit different to adults’ migraines and, because their bodies are still growing, they react differently to these medications too. That means that what works for your parents will not necessarily work for you.
If a child or teenager has really severe migraines several times a month, they sometimes take certain medications that have been approved for adults to try to prevent attacks. None of these have been licensed for use in Germany for children and young people, because there is not enough evidence that they are both safe enough and effective for young people as well.
If things are really bad for you, though, your doctor might talk with you about the possibility of carefully trying out one of these medicines. If you do take one, then he or she will want to see you a few times a year to see how you are getting on with it. You could be growing out of your migraines, so it is important to have regular check-ups.
What to do when you have a Migraine
When you have a severe migraine, you will probably need to lie down in a quiet and dark place until you can get to sleep or the migraine is over. If you can get to sleep, the migraine will probably be gone when you wake up again. A cold pack for the side of your head that hurts could help reduce the throbbing.
The medication that has been shown to help the most in children and teenagers who have a migraine are the painkillers ibuprofen and acetaminophen (paracetamol). They can help reduce the pain and the throbbing. Ibuprofen might work for a little longer than acetaminophen. Side effects are not very common for either medication, particularly if you do not take a lot of medicine, but sometimes ibuprofen and acetaminophen can cause stomach problems.
Medication specifically for migraines: triptans
Besides painkillers, there are also medications developed specifically for the treatment of migraines: they are called triptans. But none of the triptans have been clearly proven to work well for children under the age of 12. If you are 12 years old or older, you can try a nasal spray for your migraine. Imigran is one of its trade names and it has the drug sumatriptan in it. When you use this spray, it is enough to just use a single squirt in one nostril.
However, it is not certain that Imigran nasal spray is any more effective overall than tablets containing ibuprofen, and it has more side effects. The spray often leaves an odd taste in your mouth. Other side effects are less common, and include drowsiness and a stiff jaw. But trying out this nasal spray may be worth your while: for example, if ibuprofen or acetaminophen have not helped against your migraines.
Drugs for nausea
Some migraine medications have a drug in them called metoclopramide. That drug is used for nausea, but there has not yet been any research on the effectiveness of metoclopramide for children and teenagers with migraines.
Adults have more drugs to choose from, because more drugs have been tested in adults than in children. But, again, results from research with adults cannot simply be applied to children and young people. So we cannot know if they are also safe enough and effective for children and young people. If ibuprofen, acetaminophen and Imigran do not work for you, then your doctor might talk with you about other possible options.
It is very easy, though, to end up taking too much medication if you have a lot of headaches. It is better to try not to rely on medication, and only take it when you really need it.
Most children and teenagers will get through their migraines if they lie down quietly, use a cold pack for where it hurts the most, and take ibuprofen or acetaminophen if it gets really bad. Support from your parents is also important. Remember, there is a very good chance that you will outgrow your migraines over time.
Author: Institute for Quality and Efficiency in Health Care (IQWiG)
Next planned update: March 2015.