How to help a child with migraines

Headaches in children - Diagnosis and treatment

Diagnosis

To learn about the nature of your child's headache, your doctor will likely look to:

Headache history. Your doctor asks you and your child to describe the headaches in detail, to see if there's a pattern or a common trigger. Your doctor may also ask you to keep a headache diary for a time, so you can record more details about your child's headaches, such as frequency, severity of pain and possible triggers.
Physical exam. The doctor performs a physical exam, including measuring your child's height, weight, head circumference, blood pressure and pulse, and examining your child's eyes, neck, head and spine.
Neurological exam. Your doctor checks for any problems with movement, coordination or sensation.

If your child is otherwise healthy and headaches are the only symptom, no further testing usually is needed. In a few cases, however, imaging scans and other evaluations can help pinpoint a diagnosis or rule out other medical conditions that could be causing the headaches. These tests may include:

Magnetic resonance imaging (MRI). MRIs use a powerful magnet to produce detailed views of the brain. MRI scans help doctors diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities. An MRI can also be used to examine the blood vessels that supply the brain.
Computerized tomography (CT) scan. This imaging procedure uses a series of computer-directed X-rays that provide a cross-sectional view of your child's brain. This helps doctors diagnose tumors, infections and other medical problems that can cause headaches.
Spinal tap (lumbar puncture). If your doctor suspects that an underlying condition, such as bacterial or viral meningitis, is causing your child's headaches, he or she may recommend a spinal tap (lumbar puncture). In this procedure, a thin needle is inserted between two vertebrae in the lower back to extract a sample of cerebrospinal fluid for laboratory analysis.

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CT scan
Lumbar puncture (spinal tap)
MRI

Treatment

Usually you can treat your child's headache at home with rest, decreased noise, plenty of fluids, balanced meals and OTC pain relievers. If your child is older and has frequent headaches, learning to relax and manage stress through different forms of therapy may help, as well.

Medications

OTC pain relievers. Acetaminophen or ibuprofen (Advil, Motrin IB, others) can typically relieve headaches for your child. They should be taken at the first sign of a headache.

Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children. Talk to your doctor if you have concerns.
Prescription medications. Triptans, prescription drugs used to treat migraines, are effective and can be used safely in children older than 6 years of age.

If your child experiences nausea and vomiting with migraines, your doctor may prescribe an anti-nausea drug. The medication strategy differs from child to child, however. Ask your doctor or pharmacist about nausea relief.

Caution: Overuse of medications is itself a contributing factor to headaches (medication overuse headache). Over time, painkillers and other medications may lose their effectiveness. In addition, all medications have side effects. If your child takes medications regularly, including OTC products, discuss the risks and benefits with your doctor.

Therapies

While stress doesn't appear to cause headaches, it can act as a trigger for headaches or make a headache worse. Depression also can play a role. For these situations, your doctor may recommend one or more behavior therapies, such as:

Relaxation training. Relaxation techniques include deep breathing, yoga, meditation and progressive muscle relaxation, in which you tense one muscle at a time. Then you completely release the tension, until every muscle in the body is relaxed. An older child can learn relaxation techniques in classes or at home using books or videos.
Biofeedback training. Biofeedback teaches your child to control certain body responses that help reduce pain. During a biofeedback session, your child is connected to devices that monitor and give feedback on body functions, such as muscle tension, heart rate and blood pressure.

Your child then learns how to reduce muscle tension and slow his or her heart rate and breathing. The goal of biofeedback is to help your child enter a relaxed state to better cope with pain.
Cognitive behavioral therapy. This therapy can help your child learn to manage stress and reduce the frequency and severity of headaches. During this type of talk therapy, a counselor helps your child learn ways to view and cope with life events more positively.

More Information

Biofeedback
Cognitive behavioral therapy

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Lifestyle and home remedies

OTC pain medications, such as acetaminophen or ibuprofen (Advil, Motrin IB, others), are usually effective in reducing headache pain. Before giving your child pain medication, keep these points in mind:

Read labels carefully and use only the dosages recommended for your child.
Don't give doses more frequently than recommended.
Don't give your child OTC pain medication more than two or three days a week. Daily use can trigger a medication overuse headache, a type of headache caused by overuse of pain medications.
Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children. Talk to your doctor if you have concerns.

In addition to OTC pain medications, the following can help ease your child's headache:

Rest and relaxation. Encourage your child to rest in a dark, quiet room. Sleeping often resolves headaches in children.
Use a cool, wet compress. While your child rests, place a cool, wet cloth on his or her forehead.
Offer a healthy snack. If your child hasn't eaten in a while, offer a piece of fruit, whole-wheat crackers or low-fat cheese. Not eating can make headaches worse.

Alternative medicine

Although they haven't been well studied, a number of dietary supplements have been suggested to help children's headaches, including:

Riboflavin
Magnesium
Coenzyme Q10
Vitamin D

Check with your child's doctor before trying any herbal products or dietary supplements to be sure they won't interact with your child's medicine or have harmful side effects.

Several alternative treatments may also be helpful for headaches in children, including:

Acupuncture. Acupuncture practitioners use extremely thin, disposable needles that generally cause little pain or discomfort. Some research has suggested that this treatment may help relieve headache symptoms.
Massage. Massage can help reduce stress and relieve tension, and may help ease headaches.

Preparing for your appointment

Typically, you make an appointment with your family doctor or your child's pediatrician. Depending on the frequency and severity of your child's symptoms, you may be referred to a doctor who specializes in conditions of the brain and nervous system (neurologist).

Here's information to help you get ready for your child's appointment and to know what to expect from the doctor.

What you can do

Write down your child's signs and symptoms, when they occurred, and how long they lasted. It may help to keep a headache diary — listing each headache, when it happens, how long it lasts and what might have caused it.
Make a list of all medications, vitamins or supplements your child is taking.
Write down questions to ask your doctor.

For headaches in children, some basic questions to ask your doctor include:

What's the most likely cause of the symptoms?
Are tests needed to confirm the diagnosis?
What treatments are available and which do you recommend?
Does my child need prescription medication, or would an OTC medication work?
What follow-up, if any, is needed?
What can we do at home to lessen the pain?
What can we do at home to prevent headaches?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

When did the symptoms start? Have they changed over time?
How often does your child experience these symptoms?
How long does the headache usually last?
Where does the pain occur?
Have the symptoms been continuous or intermittent?
Does your child have other symptoms, such as nausea or dizziness?
Does anything make your child's symptoms better?
Does anything make the symptoms worse?
What treatments have you tried?
What medications does your child take?
Do other family members get headaches?

What you can do in the meantime

Until you see your child's doctor, if your child has a headache, place a cool, wet cloth on your child's forehead and encourage him or her to rest in a dark, quiet room.

Consider giving your child OTC pain medications such as acetaminophen or ibuprofen (Advil, Motrin IB, others) to ease symptoms.

Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children. Talk to your doctor if you have concerns.

By Mayo Clinic Staff

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Treatment of Migraine in Children

Published: September 14, 2017

Pediatric migraine is unique, and it requires an individualized treatment plan with the aid of specialists who understand and have expertise in the diagnosis and treatment of migraine. But while professionally crafted strategies are the cornerstone of effective migraine treatment in children, don’t underestimate the relief that you, the parent, can provide your child by offering reassurance and understanding.

In that spirit, it’s essential to understand what your child is going through and what their treatment entails. Knowing how to assist your child will go a long way in helping them lead a fulfilling life.

Mild- vs. severe-migraine treatment

The approach to migraine treatment depends on the level of disability a child or adolescent experiences. If the person experiences mild disability—for instance, they miss just an hour of class, do not experience severe pain or have only minimal associated symptoms—then the treatment can be as easy as taking a break and resting until the symptoms have passed. Creating a calm, quiet and safe environment while soothing your child for the duration of his or her migraine can provide tremendous comfort during what may be a painful and scary experience.

However, if the migraine attacks cause a moderate-to-severe disability—pain that lasts for two to six hours—and prevents the child from staying in school or participating in his or her usual activities, your provider should recommend an abortive (also referred to as acute or rescue) medication. Abortive medications are intended to reduce or terminate migraine. These medications are typically most effective if administered at the onset of symptoms when the pain is still relatively mild.

How to treat migraine in children

Acute medication

Migraine appears to result from a genetically “sensitive” brain, wherein the pathways that normally conduct head pain are activated too easily. It is thought to be a “neuro-inflammatory” disorder, as the activation of the head pain pathways is accompanied by inflammation around the blood vessels within the lining of the brain.

Two of the most effective classes of medications available for acute migraine treatment are:

Non-steroidal anti-inflammatory medications (NSAIDs): Examples are ibuprofen and naproxen sodium. These medications decrease the inflammatory process, and their effectiveness may be enhanced by taking them in conjunction with caffeine.
Triptans/ergots: These medications interrupt the chain of physiologic events that generate and sustain a migraine attack. They are designed to alleviate migraine within two to four hours, preferably in as little as one to two hours. The triptan group includes tablets and nasal sprays, as well as injectable forms. Dihydroergotamine is available in nasal spray or injectable formats; when necessary, compounding pharmacies can make other formulations.

It’s important to remember that children and adolescents should limit acute pain treatment to two days a week. If your child needs abortive medication more frequently, notify their provider. Just as adults can transition from frequent episodic to chronic daily headache, so can children. This is why it is important to monitor your child’s frequency of migraine, use of acute medication, and the response to treatment.

It should also be noted that opiates or narcotics are discouraged for use in pediatric migraine treatment. They may cause sedation or even dependence if used too often, and can make chronic daily headache harder to treat in the long run.

Preventive treatment

Infrequently, children or adolescents who are experiencing migraine attacks more than twice a week may benefit from additional treatment with preventive therapy. Preventive medications are taken daily to prevent migraine attacks and to stabilize patients when headache frequency has risen to an unacceptable level. Many patients will only require preventive therapy for a few months; once their headache frequency has declined and remains at a low level, they may be tapered off the preventive medication and be able to maintain a lower headache frequency with lifestyle modifications alone.

Effective preventive medication may also improve the patient’s response to abortive therapy. Often, medications are used when a patient might benefit from a potential side effect (e.g., promoting sleep or decreasing appetite). Your child’s healthcare provider will review their headache history, identify any comorbidities (other disorders that coexist with migraine, e. g., depression) and discuss which preventive medication is likely to be the best option.

Additionally, there are neuromodulation devices that may be used for the prevention of migraine, such as the supraorbital nerve stimulator, vagus nerve stimulator, and the transcranial magnetic stimulator.

Cognitive behavioral therapy

In addition to medication, cognitive behavioral therapy is often effective in reducing migraine frequency. Children with migraine are very sensitive to stress, and sudden changes in the level of stress may trigger an acute attack. Chronic stress may also reinforce chronic migraine. Biobehavioral management helps patients understand how better to control stress, and understand when to utilize additional therapies during headache attacks.

Lifestyle adjustments

Children experiencing an increase in headache frequency may benefit from lifestyle modifications aimed at increasing hydration and sleep, eating regular meals, reducing stress, taking regular breaks in a busy schedule, being more active, and reducing frequent rescue medication use.

Here are some general guidelines:

Hydration: eight to 12 glasses of a non-caffeinated beverage per day.
Sleep hygiene: eight to 10 hours of sleep at night, going to bed and waking up at the same time every day.
Exercise: 30-60 minutes/day most days of the week (preferably aerobic conditioning—e.g., jogging, lap swimming and cycling).
Nutrition: Three meals daily at regular intervals, focusing on foods that are low in fats and sugars while emphasizing vegetables and protein.

Working with a trusted professional

Finally, it is important to follow the recommendations from your child’s healthcare provider carefully and report any side effects or lack of improvement rather than simply stop treatment. With some positive changes in lifestyle, an appropriate regimen for the treatment of acute headache and a well-chosen preventive treatment, a child experiencing uncontrolled migraine attacks can typically anticipate significant improvement and, consequently, improved quality of life.

For help finding a specialist in your area, check out the American Migraine Foundation’s Find a Doctor tool. For more information about pediatric migraine, visit the AMF Resource Library.

This blog was updated in March 2020.

Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.

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Help a child with migraine and headache? Treatment of migraine in children, childhood migraine

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Do children have migraines?

Yes, it happens! More than half of adults indicate that their first migraine attack occurred in childhood - before the age of 15 years. However, in many children, migraines can begin even under the age of 5 years. So actually migraine in children is much more common than is commonly believed.

Migraine in children is generally the same as in adults. However, in children, the pain is more often bilateral. If your child has intermittent vomiting or abdominal pain for which no explanation can be found, this may be the start of a migraine . Be sure to mention these symptoms to your doctor.

Does your child complain of a headache?

If your child complains of a headache, try to calm him down, say that "it'll all be over soon." But if this is the first time this has happened, or if the headache is different from the usual (for example, more severe), start looking for its cause. You should never just think that your child is complaining about a headache in order to get attention or to get an opportunity not to do something. Seeing your distrust and irritation, the child experiences tension and it is more difficult for him to cope with pain. You can't ignore a new headache. You know your child better than his teachers or friends. And a headache can be very frightening for him, and in some cases (although very rarely) dangerous to health.

How can you tell if a child has a migraine?

In children, during a headache, the mood most often deteriorates, they experience nausea, headache, often one-sided. Sometimes the attack may be preceded by an aura.

If the headache occurred for the first time or the attacks started only recently, and also if the headache has changed its character (became more intense, vomiting, blurred vision), be sure to consult a pediatrician or, better, a pediatric neurologist . Be prepared to give the doctor the following information:

How long does the headache last?
How often does this happen?
Have you noticed what causes seizures?
Where is the pain located and what is its nature?
Are there any accompanying symptoms (eg sensitivity to light, nausea)?
How can an attack be stopped?

If you have a frequent headache, start keeping a diary. If you have any of your child's test results, please bring them with you to your child's appointment. neurologist .

How to treat migraine in children?

Please note that children cannot be treated in the same way as adults. Most medications (both painkillers and those meant to prevent migraine) have not been tested in children, and some are banned altogether. So please be careful. For example, children under 12 should not be given aspirin. Instead, paracetamol (acetaminophen, panadol) or ibuprofen (nurofen, mig) is used for pain relief. To reduce nausea, you can take metoclopramide (cerucal, raglan). Never give children any medicine just because you usually use it! For the treatment of migraine in your child, all recommendations and prescriptions must be issued by a doctor. Discuss any medications you give or plan to give your child with your pediatrician or pediatric neurologist .

Inform school teachers and the school nurse that your child has a migraine. This will help him avoid misunderstandings from staff and other students. Also, remember that migraine medications work best when taken early in the attack. If your child's migraine attacks are usually intense, accompanied by nausea or vomiting, then he needs to take medication. And it is easier to do this if the teacher or nurse prompts him in time to take the medicine. Sometimes it is enough for a child to simply relax in a dark, quiet room, and for this you need to enlist the support of the school nurse. Do not draw too much attention to your child's headache, you do not need to make him an invalid. Try not to create a situation in which it becomes clear to the child that he receives your undivided attention and can not do unwanted things (not do homework, not help you around the house) only if he has a headache. Tell him that such a headache is safe and will pass soon, that he needs to take medicine or lie down for a while in silence, and soon he will be able to play and do his usual activities again.

So, during a migraine attack in a child:

Try to avoid medication.
Give your child the opportunity to relax in a dark, quiet room.
Give the child something to eat (something sweet can be) and drink.
If necessary, give half or a whole tablet of paracetamol or ibuprofen. These preparations also exist in the form of a suspension.
If the attack still unfolds and there is severe nausea, you can take Cerucal.
Combination analgesics (Pentalgin, Caffetin) are approved for use in children over 12 years of age
The only triptan approved for use in children is Imigran in the form of a spray.
If you have to give your child pain medication more than twice a week, discuss migraine prevention with your pediatrician.
In children, seizures become more frequent under the influence of the same provocateurs as in adults. Therefore, in case of frequent seizures, try to identify triggers for seizures in your child.

The following rules for living with a migraine can greatly help your child:

Do your best to establish a sleep schedule - it is advisable for the child to go to bed and wake up at about the same time every day, including weekends.
Encourage your child to participate in sports, fitness, gymnastics, as this reduces stress, anxiety, improves mood and allows you to control weight (all of these factors are risk factors for more migraine attacks).
The child should eat regularly and not skip meals because low blood glucose levels can lead to a migraine attack. Try to arrange for your child to eat more fresh foods that are free of preservatives and chemical additives.
Try to reduce the amount of caffeine your child gets. It is advisable not to exceed one cup of carbonated drinks per day.
Make sure your child drinks enough, especially during the summer.
If migraine attacks are still frequent, focus on non-drug approaches. Children can benefit greatly from biofeedback and relaxation techniques.

If necessary, magnesium supplements can be taken to reduce migraine attacks. If the pain is frequent and the child is forced to take painkillers more than 10 days a month, see a doctor to deal with this situation in time. Some migraine medications that are used in adults are also approved for use in children. As a parent, you have a very important function to educate yourself and teach your child how to manage their migraine. Migraine is a benign disease and should not be a serious problem for your child.

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symptoms, causes and treatment, what is aura, abdominal and retinal migraine

Victoria Zorina

saves her daughter from migraine

Author’s profile

migraine.

Despite her young age, her daughter suffers like an adult: with an aura, sometimes nausea, and problems with peripheral vision.

I'll tell you how we cope with childhood migraine, which doctor to go to and what to do during attacks.

See a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

Causes and types of migraine in children

Migraine is a disease with attacks of severe headache that last from 4 to 72 hours. Adults usually have headaches on one side, while children often have bilateral headaches. It can be throbbing and aggravated by physical activity, accompanied by nausea and sensitivity to light, sounds or smells.

Primary headaches in children and adolescents N.I. PirogovaPDF, 2.62 MB

Migraine in children - article for patients on Updatedate

Classification of migraine in children - Uptodate

The exact reasons why children develop migraine are unknown. Now it is believed that there is a genetic predisposition to it.

The first attack of migraine can occur even in early childhood. According to various sources, about 2.5% of children under the age of 7 have migraine, by the age of 10 this figure increases to 5%. At the same time, chronic migraine with attacks at least 15 days a month is observed in approximately 1-2% of adolescents. In general, migraine attacks are unpleasant, but usually do not have long-term consequences and do not lead to health problems.

Childhood migraine may or may not have an aura. An aura is a temporary state that usually occurs before an attack of pain, 5-60 minutes before it. Most often, this is visual impairment in the form of stripes or spots in front of the eyes, but it can manifest itself as numbness of the limbs or problems with speech.

Symptoms of childhood migraine: how it differs from adult migraine

Sergey Zaitsev

pediatric neurologist, Candidate of Medical Sciences, Medical Center "Neuro-Med"

Childhood migraine attacks often proceed differently than in adults. In adults, classic migraine is more common: attacks of acute severe pain with nausea and vomiting, sometimes an aura, pain is felt on one side in the temporo-orbital region, this is called hemicrania. Descriptions of such classic seizures can be found in the literature.

Children often have bilateral pain, and not in the temporal region, but in the forehead, crown, and back of the head. At the same time, they, like adults, do not necessarily have seizures, but may be accompanied by nausea and vomiting. Another of the classic signs is intolerance to bright lights and sounds. The mood often changes, problems with mental performance appear.

At the same time, seizures in children, compared to adults, are usually shorter, often less intense and may be atypical - for example, autonomic symptoms occur: the child turns pale, dizzy, circles appear under the eyes, stuffy nose or ears.

In adults and adolescence, migraine is more common in girls and women, and in children under 10 years of age, migraine, especially classic with aura, is more common in boys.

How my daughter got her first migraine attacks

In September 2019, my daughter, who was 10.5 years old, complained of a headache for the first time. She explained that it hurts only on one side. The pain was not related to stress: the daughter is a good student at school, but does not consider her studies to be an important enough reason to worry. In addition, the school year began just two weeks before the first attack. An hour later, the daughter vomited, and then everything went away.

Headaches in children - Uptodate

Pathopsychology, clinical features and diagnosis of migraine in children - Uptodate

Two days later the situation repeated itself, but the attack began with an aura - darkening in the eyes and asterisks, as the daughter described this condition. This time we tried to stop the pain with the Ibuklin Junior tablet, and the head stopped hurting about half an hour earlier.

Ibuklin Junior contains 100 mg ibuprofen and 125 mg paracetamol, the price in pharmacies is from 90 R. Source: "Sbermegamarket"

One episode could be left without attention, but repetition required to see a doctor. Deciding that the migraine was associated with rapid growth and the onset of puberty, we still turned to the pediatrician at the compulsory health insurance clinic for a referral to a neurologist. The pediatrician confirmed my assumption and gave me a referral.

The neurologist turned out to be a young professional who asked her daughter in detail about her symptoms, well-being and possible causes of migraine. I liked that he did not look for confirmation from me and seriously approached the questioning and examination of the child. He also approved the use of Ibuklin Junior tablets according to the instructions, since they help, and asked to come to the reception if the situation repeats. The doctor did not prescribe any additional examination, as he did not see any alarming symptoms.

The neurologist suggested that migraine attacks are associated with hormonal changes in the body. Judging by the further development of events, it is so: we have not found other reasons that could provoke a migraine.

Symptoms and causes of migraine - Mayo Clinic blog

Diagnosis of childhood migraine

Sergey Zaitsev common primary headaches. That is, pains that occur on their own and are an independent disease, in contrast to secondary headaches, which will be a sign of another underlying disease.

Tension headache in children is diagnosed successfully, but migraine is often difficult to diagnose. To begin with, a child cannot always accurately describe his feelings. Usually children just complain that their head hurts, but it is rather difficult to understand where and how. In addition, children often have atypical migraine attacks.

It can also be difficult to assess the intensity of headaches in children. Adults easily rate their feelings on a scale from 0 to 10, children have to offer visual images, such as pictures, emoticons. Here it is important to focus on the story of adult loved ones: how the behavior and well-being of the child changes, how mood and performance are disturbed. By such signs, you can also determine the strength of the headache.

If there are classic seizures and there were more than 4-5, the diagnosis is made clinically, that is, according to the results of the medical history and medical examination. Additional research is usually not needed.

In other situations, when secondary headaches are suspected, other causes usually need to be excluded. Then additional studies are ordered.

For example, if there is a suspicion of a tumor, an MRI of the brain is done, and if there is a vascular pathology, an examination of the vessels of the neck and head is done. In cases where there is information about injuries or some past infections, an additional examination is also sometimes prescribed.

Very rare, but it happens that video-EEG monitoring may be required: there are epileptic headaches with vomiting, nausea, occurring in the occipital region, mainly at night. Then the exclusion or confirmation of epilepsy is necessary.

Treatment of migraine in children and adolescents

When a child has recurring or prolonged headaches, it is always best to visit a neurologist so that he can select a treatment.

Acute treatment of migraine in children - Uptodate

You should immediately consult a doctor if the pain begins after a head injury, appears in the morning, that is, the child wakes up from pain, or is accompanied by stiffness in the neck, fever, fainting and impaired coordination of movements. In such cases, the headache may be caused by something else, not a migraine, but something more serious.

Our doctor did not find any special reasons for concern, but advised us to call an ambulance if the attack does not go away for more than 15-20 minutes and is accompanied by vomiting, impaired vision or coordination, numbness or weakness in the limbs. And also contact him again if the attacks recur, or lie down for an examination if they become more severe.

Children's migraines are treated with painkillers to be taken during attacks. As a rule, these are the usual analgesics from the pharmacy: paracetamol and ibuprofen, which are sold without a prescription. They cannot be taken more than 14 days a month, otherwise abuse headaches will appear, that is, pain caused by the medicine itself. It is also worth reading the instructions if you need to relieve an attack with medicine from a home first aid kit before consulting a doctor. Not all drugs are suitable for children - for example, aspirin is contraindicated under 15 years of age due to the risk of complications such as Reye's syndrome.

/migraine/

How much does it cost to keep a migraine under control

If conventional painkillers don't work, your doctor will prescribe prescription drugs called triptans. These drugs are intended for the treatment of migraine. They should not be drunk more than 9 times a month.

You also need to exclude triggers - things that can provoke an attack. In children, it can be skipping meals, stress, lack of sleep, certain foods, such as nuts or coffee.

At our first appointment, the neurologist gave us written recommendations on what to do and not to do for migraine, and also allowed us to use triptans, prescription drugs for the treatment of migraine, if conventional painkillers no longer help.

During an attack of pain, the doctor advised the following regimen:

Take Ibuklin Junior or Nurofen in age-appropriate doses.
If painkillers do not help, drink Sumatriptan - according to the instructions, it is possible only from the age of 18, but triptans are also prescribed abroad for young children. The dosage here is determined only by the doctor, you cannot take such drugs on your own.
For nausea, add Cerucal or Domperidone.

He also advised to avoid certain foods and drinks: cola, coffee, hot spices, some cheeses, chocolate with additives, bananas, nuts, legumes, tomatoes. These foods can become a trigger - a migraine provoking factor. However, he allowed dark bitter chocolate and green tea. In addition, advised to avoid psycho-emotional stress before bedtime.

/list/pediatr-deti/

11 important questions to pediatrician Sergei Butriy

The neurologist recommended limiting psycho-emotional stress, and in case of a severe attack, call an ambulance. I didn’t make a diagnosis of migraine: I think because the attack was a single one. “Sumatriptan” is named after the active substance, other trade names are “Sumamigren”, “Rapimed”, “Amigrenin”, the price is from 77 R. Source: Lekas

Peculiarities of treatment and prevention of childhood migraine

Sergey Zaitsev

pediatric neurologist, candidate of medical sciences, medical center "Neuro-Med"

When migraine attacks appear, you need to contact a neurologist - you definitely need to fight this disease. Even rare seizures can cause psycho-emotional disorders and a decrease in adaptive capabilities.

Migraine is not as harmless as previously thought. At the time of an attack, vascular disorders occur, brain cells suffer. This can affect quality of life and cognitive function. If the pains are frequent and severe, accompanied by obvious neurological symptoms, then the disease is unfavorable, preventive control of seizures is needed.

It is important to quickly distinguish migraine from other types of headache and make a correct diagnosis, as this disease can be successful in a special, specific treatment.

In general, childhood migraines are treated the same way as adults. Usually, the doctor prescribes analgesics, that is, drugs that relieve pain attacks. If the attacks are short and rare, this is enough.

If the attacks are severe and frequent, it is necessary to prescribe special agents and preventive therapy. Abroad, both adults and children use approximately the same drugs.

For example, triptans for relieving attacks are included in all international protocols for the treatment of childhood migraine. We do not have such recommendations, and the instructions for such drugs indicate that they are allowed from the age of 18, although in other countries they are successfully prescribed to younger children.

It is the same with migraine prevention products: we have a wide arsenal of medicines available only to adults, while children and adolescents do not have the opportunity to officially use the latest highly effective drugs.

On the other hand, non-drug methods and regimen recommendations work very well for children. You can achieve an excellent result if you provide the child with sufficient sleep, systemic physical activity, limit the time of watching videos, and remove excessive intellectual and emotional stress.

As a rule, children do not have such a strong dependence of migraine attacks on food triggers as adults. If adults are advised to immediately exclude certain foods, then children often keep a food diary and analyze which product can provoke an attack. Usually these are foods with a high content of tyramine: dried, dried, smoked and pickled products, aged cheeses, nuts, chocolate, as well as foods with a lot of food additives: flavor enhancers, flavors, preservatives, and the like.

How repeated attacks of migraine proceeded

Almost a year later, in August 2020, my daughter fainted in the bathroom, and the next day she had a migraine. As before, nothing affected the occurrence of seizures: there was no stress, the sleep and diet regimen did not change. We again went to the doctors, the pediatrician habitually wrote out a referral to a neurologist, as well as blood, urine and ECG tests. Everything was in order there.

This time, the neurologist ordered additional examinations for my daughter, because before the attack she had fainted: an ophthalmologist's consultation, an electroencephalogram, an ultrasound examination of the arteries of the neck. She passed all of them free of charge according to compulsory medical insurance, no deviations from the norm were found.

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The main result of the visit to the doctors was the final visit to the neurologist. He studied the results of the examinations, repeated the previous recommendations and recommended to come for an examination if loss of consciousness or migraine recurs within three months. However, this did not happen.

In May 2021, my daughter started having migraines with aura again. The first time, Ibuklin Junior did not help her, and I gave her half a triptan tablet. This helped relieve the seizure.

The next day everything happened again. New symptoms have been added: loss of peripheral, that is, lateral, vision, numbness of the legs and arms on the side of the migraine. While we were thinking whether to call an ambulance, the pill worked and everything went away.

Two days later she had a third attack, not as difficult as the second one, and we again went to the clinic. The neurologist examined her daughter for a long time and offered not only to visit an ophthalmologist, but also to do an MRI of the brain to rule out a stroke.

He issued a referral to the Morozov hospital, but there a free MRI could be done only after a month. I managed to sign up for the same fee the next morning because someone canceled the appointment.

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MRI of the brain with arteriography — assessment of the condition of the arteries — cost 8300 R. In Moscow, you can find cheaper options, but I decided that it would be better to have the examination done in a children's hospital, and not in private medical center. Fortunately, according to the results of the study, nothing unusual was found. The daughter, who was obviously nervous about what was happening, perked up after reading the conclusion, and so did I.

After the examinations, we returned to the neurologist, who wrote the final report and let me go home.

Since then, my daughter had one short migraine attack with aura in July. There were no vision problems or numbness of the limbs. Considering that it is impossible to cure migraine, it remains only to cope with attacks with the help of pills. I hope that these attacks will pass along with the completion of hormonal changes.

The conclusion on the results of the MRI of the brain sounded encouraging At the appointment of a neurologist, according to the results of examinations, the diagnosis was "migraine with aura"

How much I spent on the treatment of migraine in a child

Due to the fact that I was lucky to find a good neurologist in the city polyclinic, I saved a lot of money: five paid appointments would cost me about 10,500-72,175 R, depending on the clinic's requests. For example, an appointment with a neurologist at the Family Doctor costs 2100-3500 R, at Dokdeti - 4000-6000 R, at GMS Clinic - 6696 R, and at EMC - 14 435 R.