Migraines & Headaches

When children experience migraines and other headaches, their quality of life both at home and at school can be affected. Genetically-influenced changes in the nerves and blood vessels in the head and face likely cause migraines and other headache disorders. If your child has frequent headaches, he or she may need to be evaluated and treated by a doctor.

Types of headaches include:

Migraine
Chronic tension headache
New daily persistent headache
Headaches that are symptoms of other medical conditions

Chronic tension headaches are the most common type of headache in children that leads to medical evaluation.

Typical tension headache symptoms include:

Slow onset of pain
Head pain on both sides
Pain is mild to moderate
Pain may affect the back of the neck

Migraine headaches may follow four phases:

Premonition phase. Your child may show a change in mood or behavior.
Aura phase. Your child may experience unusual feelings before a migraine headache, such as visual changes, numbness and tingling and trouble pronouncing words.
Headache phase. Your child will feel moderate to severe (but often throbbing) pain on one or both sides of the head. The pain may last several hours. During this phase, your child may be sensitive to light and sound, experience nausea and vomiting and avoid movement or activity,
Headache resolution phase. After the headache pain goes away, your child will likely feel exhausted and weak.

Symptoms vary for other headache types.

Although headaches are not often medically harmful, they can cause your child to miss school and other activities. Frequent and recurring headaches are also associated with anxiety, depression and sleep disorders.

Diagnosis of Migraines & Headaches

The first step is to rule out any underlying medical issues that may be causing the headaches. Next, your child’s doctor will ask about certain headache triggers, such as lack of sleep or poor diet. The doctor will also ask a series of questions to pinpoint the specific type of headache causing your child's pain. This will be followed by a physical exam.

In most patients with headache disorders, medical tests are unable to determine the specific cause of the headaches. If there is concern that the headaches may be due to an underlying medical condition based on their description or a physical exam finding, further testing may include:

Lab tests. Your child's doctor may run a variety of tests to rule out other conditions or diagnose the cause of headaches. Lab tests include:
- Blood test. Blood tests check for anemia, thyroid disorders and other imbalances of vitamins and electrolytes, which can contribute to headaches.
- Lumbar puncture. This test checks the spinal fluid that surrounds the brain and spinal cord.
Magnetic resonance imaging (MRI). A MRI scan uses powerful magnets to create detailed pictures of the brain.

Treatments

At Riley at IU Health, a team of neurologists and other pediatric specialists—including experts in pain management, psychology, nutrition and sleep medicine—manage migraine and headache disorders.

The goal of treatment is to prevent your child’s headaches and reduce symptoms when headaches do occur, so your child can fully participate in his or her daily routine. Treatments for migraines and headaches are specific to the type of headache and are tailored to the individual patient. Therapies focus on reducing frequency and severity of headache attacks, and patients are frequently re-evaluated to gauge their progress.

Treatment options include:

Medications. Your child’s doctor may prescribe medicines to treat or prevent migraine headaches. Some medicines used for migraine headaches work with receptors in the nerves and blood vessels to stop migraines. Frequent migraines can be treated with daily preventive medicines.
Biofeedback. Your child may receive specific biofeedback and relaxation training to reduce pain and prevent headaches. A pain psychologist can teach your child certain breathing and relaxation techniques used to relieve pain and reduce headache frequency. These techniques are also helpful for headache patients who also have anxiety or difficulty sleeping.
Nerve block. This treatment combines an injection of a numbing medication to block the function of specific nerves as a way to stop pain and prevent headaches.

Lifestyle adjustments also can help decrease headaches. Regular and adequate sleep is essential. Regular meals, including breakfast, will prevent headaches triggered by fasting. Good hydration is also important. Overuse of caffeine or over-the-counter pain medicines may actually increase the frequency of headaches and should be avoided.

Key Points to Remember

Migraines and headaches can cause moderate to severe pain.
Chronic tension headaches are the most common type of headache in children that leads to medical evaluation.
Although headaches are not often medically harmful, they can cause your child to miss school and other activities. They may also be associated with anxiety, depression or sleep disorders.
Most headache disorders are diagnosed with a clinical history and exam. Lifestyle modification, medicines, biofeedback and nerve blocks are used to treat headache disorders.

Support Services & Resources

Visit the links below to learn more about migraines and headaches and find support groups.

We offer a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

National Institute of Neurological Disorders and Stroke - Migraines

This government website provides information about treatment and research related to migraines.

National Institute of Neurological Disorders and Stroke - Headaches

Learn more about treatment for headaches from the National Institute of Neurological Disorders and Stroke.

Locations

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