What is migraine?

What is migraine?

Migraine is a neurological condition that involves attacks of head pain, nausea, fatigue and a range of other symptoms. Migraine attacks last between four hours and three days and the patient feels well between attacks. The cause of migraine is unknown but there is often a genetic factor.

Common symptoms of migraine:

• Head pain, this can be severe and is often unilateral
• Nausea and vomiting
• Fatigue
• Sensitivity to light, sound and smells
• Aura: Problems with vision (e.g. seeing flashing lights, zigzags or blindspots), speech or hearing

Other symptoms of migraine:

• Dizziness or vertigo
• Weakness down one side of the body
• Numbness or pins and needles
• Nasal congestion
• Mood changes
• Loss of consciousness

How migraine presents in children

Migraine can present differently in children than in adults. Often, head pain is absent and the child experiences stomach pain instead. This is known as abdominal migraine and affects four percent of children. Children with abdominal migraine often develop migraine with head pain as they age.

Common symptoms of migraine in children:

• Headache, this may be unilateral, bilateral, or at the front of the head
• Stomach pain
• Nausea and vomiting
• Sensitivity to light, sound and smells
• Aura: Problems with vision (e.g. seeing flashing lights, zigzags or blindspots), speech or hearing
• Looking pale
• Tiredness

Migraine is more common in boys than girls before puberty, and then becomes more common in girls with the onset of puberty. This is because changes to female hormone levels can trigger migraine attacks.

The impact of migraine on children and young people

Migraine can have a significant impact on children and young people. It may affect their school attendance and performance, friendships and relationships, and their ability to partake in extra-curricular activities. This, in turn, can affect their quality of life and their mental health.

The impacts of migraine on children and young people should not be underestimated. Migraine attacks can be extremely painful and debilitating, which can be very distressing for a child and their family. Some children with migraine may need to be referred to mental health services for additional support.

Chronic migraine

Although rare, some children develop chronic migraine. This is defined as having headache on at least 15 days each month, with migraine symptoms on at least eight of those days. Chronic migraine can have serious effects on school attendance, social life, and overall wellbeing. Episodic migraine can become chronic at any time so it is vital that episodic migraine is managed effectively and children and their parents are educated about the risks of medication overuse headache.

Medication overuse headache

Medication overuse headache is headache caused by frequent use of acute medication such as triptans, ergotamines, opiates, non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol. NSAIDs and paracetamol should not be used on 15 or more days each month, while ergotamines, triptans and combination painkillers should not be used on 10 or more days each month. Codeine should be avoided.