Children & Migraine: 11 Things Parents Need to Know
Migraine often looks so different in kids than adults that even parents who have migraine don’t realize their child’s symptoms are actually migraine. Here are some facts and information about children and migraine:
1. Many children have no head pain, but start with abdominal migraines, which include stomach pain, nausea and possibly vomiting.
2. If kids do have head pain, it is usually over their whole head, not confined to one side.
3. Fewer than half of kids with head pain describe it as throbbing.
4. Kids’ migraine attacks, whether they include head pain or not, are usually shorter than adults’ attacks. They often last only two or three hours.
5. Migraine frequency, severity and duration tend to increase as a child ages.
6. Colic and carsickness are common among kids with migraine.
7. Children’s migraine attacks can look suspiciously like an excuse to skip school. Attacks tend to become more frequent during the school year and often come on a Monday or Tuesday. Symptoms can come on suddenly and let up suddenly.
8. It’s important to get an accurate diagnosis and start a treatment plan as early as possible. This can help keep a child’s episodic migraine attacks from progressing to chronic.
9. Migraine preventives recommended for kids include amitriptyline, cyproheptadine and propranolol (and Topamax recently received approval for use in adolescents).
10. To stop a migraine attack that’s in process, the FDA has approved almotriptan for adolescents and rizatriptan for children and adolescents. NSAIDs, like ibuprofen (Advil), and acetaminophen (Tylenol) could also be effective.
11. Opioids (narcotics) should never be the first-line treatment for kids. Fioricet is rarely the best treatment option for kids and should be used sparingly in limited circumstances.

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