Migraine in Children and Adolescents

Reviewed by: HU Medical Review Board | Last reviewed: February 2023

Migraine is the most common headache disorder in children. Headache is a common symptom of migraine. But it is not the only one.1

A migraine attack can look different in young people than it does in adults. Migraine symptoms in kids and teens can evolve and change. While migraine can be disabling and disruptive, there are different treatment options available.1

How common is migraine in kids?

The number of children and teens living with migraine varies by age. We know that:1,2

  • Up to 5 percent of preschool children have migraine
  • About 10 percent of school-aged children have migraine
  • Up to 28 percent of adolescents live with migraine

Migraine attacks can start at a young age. Some kids have their first attack before the age of 5. Migraine attacks have been reported in toddlers as young as 18 months.3

What does migraine look like in children and adolescents?

While many symptoms are the same, migraine attacks can look different in kids and teenagers than they do in adults. Migraine symptoms can change as kids age.1

In kids and teens, a migraine headache can:1,2

  • Last 2 to 72 hours
  • Be painful
  • Feel pulsating or pounding
  • Be felt in the front, on one side, or on both sides of the head
  • Worsen with activity

Other migraine symptoms can include:1,2

  • Stomach pain
  • Nausea
  • Vomiting
  • A stuffy nose
  • Sensitivity to light or sound

Migraine attacks may include aura

Migraine with aura is an attack that happens after or at the same time as a sensory disturbance (change in the senses). There are several kinds of aura. The most common type is visual.1,4

An aura usually happens less than an hour before a headache. It can last up to 20 minutes. Auras can occur with or without a headache.1

Visual auras can include:1

  • Blurred vision or loss of vision
  • Zigzag lines, black dots, or flashes of light
  • Kaleidoscopic patterns of colors
  • Objects looking larger or smaller than they are
  • Straight lines looking curved

Other types of aura can include:1,2

  • Numbness, weakness, tingling, or trouble moving 1 side of the body
  • Difficulty talking
  • Confusion or trouble paying attention
  • Dizziness
  • A sound of ringing in the ear

How might kids and teens act during a migraine attack?

Migraine attacks affect everyone differently. Migraine can also look different at different ages.1

Preschoolers with migraine can look ill or pale. They might complain of stomach pain or vomiting. They might need to sleep. They could show their pain by crying, being fussy, rocking, or looking for a dark room.1

Kids ages 5 to 10 may have a headache that affects the front of their head on both sides. They may look pale and have dark circles under their eyes. They may have stomach pain, feel nauseous, vomit, and be sensitive to light and sound.1

Adolescents may start to have migraine with aura. Older teens may feel head pain in one or both temples. During the attack, teens may have:1

  • Chills
  • Dizziness, poor muscle control, or a feeling of clumsiness
  • No appetite, nausea, diarrhea, or constipation
  • Sensitivity to lights or sounds
  • Confusion or trouble focusing

Common risk factors and triggers for migraine

Migraine disease usually runs in the family. If 1 parent has migraine attacks, there is about a 50 percent chance their child will.3

Many risk factors and triggers can increase the chance of having a migraine attack. Being aware of them may help you avoid an attack. Common triggers in children and adolescents include:2,3,5

  • Poor sleep or changes in sleep schedule
  • Changes in diet, skipping meals, or dehydration
  • Weather
  • Hormonal changes, including having their menstrual period or using oral birth control
  • Chemicals like caffeine, alcohol, other drugs, or certain food additives
  • Travel
  • Stress, anxiety, or bullying

Getting a diagnosis

Migraine can significantly impact a child’s life. Getting a diagnosis can help you figure out the best treatment options and how to avoid triggers. Keeping a migraine diary or a record of attacks and symptoms can help with a diagnosis.2,3

Migraine treatment options for children and adolescents

Everyone responds to treatment differently, so therapy should be specific to each person. Talk to your doctor before starting any new medicines, including over-the-counter drugs and supplements.2

During an attack, lying down in a dark, cool, and quiet room may help. Using an ice pack may help with pain.1,6

Over-the-counter drugs like acetaminophen, ibuprofen, and naproxen can offer migraine relief.6-8

A class of drugs called triptans may help relieve migraine symptoms. Triptans approved for kids and teens include:6-8

  • Almotriptan
  • Rizatriptan
  • Sumatriptan
  • Zolmitriptan

While there are some drugs available to prevent migraine in young people, lifestyle changes are recommended first.2,6,8

That includes:2,6

  • Practicing good sleep habits
  • Eating healthy and regularly
  • Staying hydrated
  • Limiting caffeine
  • Managing stress

Some alternative or nondrug treatments can help with migraine attacks. These include:3,6

  • Nerve blocks
  • Neuromodulation (the Food and Drug Administration, or FDA, has cleared a device called Nerivio for neuromodulation in people ages 12 and up)
  • Cognitive behavioral therapy
  • Biofeedback

Not all treatments or therapies work for everyone. Make sure to talk to a doctor before starting any new treatment.

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