Not just a headache: How to recognise a migraine in children


Headaches are a common ailment, but some children are experiencing debilitating migraines more than once a week.

With this in mind, it is important parents can distinguish between a normal headache and a migraine.

The Royal Children's Hospital Melbourne described migraines as a severe headache, which is often felt on one side of the head. While some children will experience a migraine every now and then, others will get them frequently, and some, more than once a week.

"Some children experience an aura (visual or sensory changes that happen just before the headache starts)," the RCHM said.

"These can be quite distressing for children, as they may see spots or zig-zag lines; be sensitive to light, sound or smell; develop tingling of the lips; or lose part of their vision. An aura typically lasts for a few minutes before disappearing when the headache begins."

Neurologist and Director of Migraine Specialist in Brisbane Dr Nicole Limberg said equal numbers of boys and girls can get migraines, yet as they grow older they're more common in teen girls and women.

"Migraine headaches are, at least, moderately severe headaches, that are frequently throbbing and unilateral (on one side), accompanied by nausea, vomiting, light and noise sensitivity," Dr Limberg said.

"Prior to puberty, boys and girls have a similar incidence of migraine. Around the time of puberty, increasing disparity exists between the two groups, with post pubescent females representing a higher ratio of approximately three to one.

"Very young children can be diagnosed with migraines, however all children under six-years-old require a complete neurological evaluation."


She said parents should look out for a number of signs their child may be experiencing a migraine.

"The pain of childhood migraine is often bilateral (on both sides) of the front and side of the child's head, and shorter in duration compared to adult migraines (two hours instead of four hours)," she said.

"Common symptoms include nausea and/or vomiting, light and or noise sensitivity. Hypersensitivity to smells can also occur.

"Some parents may be able to detect the onset of the migraine hours before it occurs because their child may show a range of symptoms, including irritability, anxiety, yawning, and difficulty concentrating."

In children, migraines can be triggered by changes to the daily schedule, increased stress, irregular sleep patterns, skipping meals, and a lack of exercise. Other triggers include bright lights (including from screens), loud noises and specific foods such as chocolate, dairy and some fruits.

And as kids grow into teens and adults - menstruation, caffeine, smoking, alcohol and oral contraceptions can also trigger migraines.

Dr Limberg suggested a range of options to treat children who suffered from migraines.

"Healthy habits are important, including adequate hydration and sleep, regular meals and exercises, and balanced nutrition," she said.

To treat a migraine, give your child paracetamol or ibuprofen, lots of water and put them to bed in a cool, dark and quiet room, and check them regularly.

It's vital parents seek medical attention if a headache awakens the child from sleep, worsens when your child is bending over or coughing, is felt at the back of the head, if there is no family history of migraines, or if your child is under six-years-old.

"Parents should also seek medical review to consider migraine prevention therapy if the headaches occur more than one day per week, particularly when accompanied by significant disability (increasing absence of school, inability to concentrate in school and/or the development of other conditions such as anxiety and depression)," she said.

"Most headaches in children are due to migraine or tension type headaches, however in a small population of patients they can be an indication of a significant underlying condition.

"Early identification of the warning signs that warrant further attention is therefore of paramount importance."