Early warning signs in children with migraine

If you have a child with migraine headaches, you know how alarming it can be to have a child with aura symptoms. These symptoms can be helpful, though, as they do indicate when to treat the migraine attack. Early treatment can get a headache under control more easily.

But what about the child who has migraine without aura? Do you know what warning signs to look for to tell that an attack is on its way?

Warning signs of impending migraine

Many migraine sufferers experience vague warning symptoms before the headache pain of a migraine begins. In fact, in adults, this type of warning occurs in more cases than auras do. A French study (Cuvellier, Mars, & Vallée; Cephalalgia, 2009) of children with migraine found that two-thirds of the children who had migraine with or without aura had at least one early warning sign, and over half had two signs. These early warning signs are called a prodrome.

The three most common warning signs were irritablilty, fatigue, and face changes. Face changes meant shadows under the eyes or pallor (paleness). The next three most common early warning signs were sensitivity to sound, anxiety or feeling stressed, and yawning. Sensitivity to light, nausea, and food cravings were also reported. Because this was a study asking about symptoms previously occurring, the length of time the warning signs lasted was not measured.

If you have a child with migraines, paying attention to these early symptoms that occur before the head pain does can pay off. Treating early can bring migraine relief and keep your child happy and active.

Children and Headaches

Children and Headaches

Migraine

Children can begin having migraine headaches at an early age. Migraines in children tend to be shorter than in adults, but are no less painful or frightening to a child, especially if a child experiences an aura.

Prior to puberty, migraines are slightly more prevalent in boys. At puberty, however, more girls begin to experience migraine headaches. migraine can be a significant problem in adolescence and, in this age group, new daily persistent headache may occur as well. New daily persistent headache starts out as a daily headache.

Other Headache Types

Tension-type headaches also occur in children, and are common in adolescents.

One type of migraine syndrome that occurs primarily in children is abdominal migraine, which usually involves nausea, vomiting, and possible abdominal pain, with or without headache. Children may appear either pale or flushed, and there may be a warning of tiredness or drowsiness.

Posttraumatic headaches are an increasingly common problem in child athletes, who should be carefully evaluated after any head injury, even if it is seemingly minor.

by Christina Peterson, MD

updated Feb 8, 2015

Heart Defect in Children with Migraine with Aura

In a small study of children with migraine (109 children six and over) the presence or absence of a heart defect known as patent foramen ovale was studied. Thirty-five per cent of the children in the study had migraine with aura. About half of the migraine with aura kids had the PFO heart defect, as compared to 27% of the children with migraine without aura.

What is PFO?

PFO (patent foramen ovale) is a form of heart defect. The foramen ovale is a hole in the heart wall that has a purpose when a baby is in the womb. It allows blood to bypass the lungs, because babies do not breathe with their lungs until they are born, and get their oxygen from the mother’s blood. Once born, this opening usually closes naturally in infants. Sometimes when it persists past infancy, a PFO will still close spontaneously, but this generally occurs before age six.

In the adult migraine population, it has been found that about 25% of all migraine patients have PFO. Trials of PFO closure in adults have been inconclusive. Several smaller, single center trials have shown high response rates to closure of PFO. The only multi-center, double-blind trial of PFO closure failed to show positive results, but was potentially flawed in terms of patient selection and other technical issues.

In this study, the severity of migraine was not associated with the presence or absence of PFO. The study was limited by the inability to place IV lines in control subjects and do a direct comparison of data from the study population and the control population. Because of the small sample size in this study and because of the other controversies associated with testing and treatment of PFO, authorities in the field have recommended further study before recommending PFO closure in children.

References:

1. http://www.jpeds.com/article/S0022-3476%2811%2900139-9/abstract

2. http://www.bbc.co.uk/news/health-12912951