Few things are harder on a parent than watching your child suffer and being unable to do anything about it.
Data presented earlier this month at the American Headache Society’s 59th annual scientific meeting in Boston looked at advanced signs of migraines in children.
Learning to recognize those signs could give patients, parents, and caregivers a heads up on what’s coming, and to have medication handy.
But timing is crucial, said Dr. Howard Jacobs, a headache specialist at Nationwide Children’s Hospital in Ohio, and senior author of the study. “You don’t want to give the medication too early or it will wear off by the time the pain starts.”
The study looked at data from 185 volunteer patients between 5 and 18 years of age, and noted what symptoms usually preceded the onset of a migraine.
Jacobs said the research focused on six of the most common premonitory symptoms typically seen in adults: fatigue, yawning, mood changes, neck stiffness, food cravings, and urinary changes.
Premonitory, or advance, symptoms are also called “prodrome.”
Jacobs told Healthline he found fatigue and mood changes were the most commonly reported prodrome symptoms. They affected 41 percent of the patients. The other four symptoms appeared insignificant in this cohort.
“Children do have migraines,” Jacobs said.
Clinicians routinely asked the patients and their parents to describe symptoms and accompanying events. That information provided the data.
“Awareness is part of an early warning system,” Jacobs said.
He explained that the sooner you recognize the symptoms, the earlier you can begin treatment.
Migraines are usually the most dreaded of headaches.
How do you know if a particular headache is a migraine?
According to the Mayo Clinic, the most common headache type is a tension headache. Triggers include stress, muscle strain, or anxiety.
Tension headaches aren’t the only type of headache, though. Other types include cluster and sinus headaches.
Migraines are intense or severe and often have accompanying symptoms in addition to head pain.
Symptoms associated with a migraine headache include: nausea, pain behind one eye or ear, pain in the temples, seeing spots or flashing lights, sensitivity to light and/or sound, temporary vision loss, and vomiting.
When compared with tension or other headache types, migraine headache pain can be moderate to severe.
Some people may experience headaches so severe they visit an emergency room.
Migraine headaches will typically affect only one side of the head but some can affect both sides.
Other differences include the pain’s quality. A migraine headache will cause intense pain that may be throbbing and will make performing daily tasks very difficult.
Input from parents
Many of the children studied were old enough to describe their symptoms, but parents were routinely questioned as well.
Jacobs said it was particularly challenging to treat teenagers with migraines, for the same reason it was hard to get their cooperation in other areas: They don’t like being told what to do.
Maintaining health in general has been linked to fewer migraines, but that doesn’t mean a rebellious 14-year-old is going to agree to behavioral changes, such as getting eight hours of sleep and eating three healthy meals every day.
“I point out that if it’s too much of a burden, maybe you’d rather have the headaches,” he said. “Getting teens to take ownership of their condition is a challenge.”
“The teen and adolescent years can be tricky for everybody — the teenager, family, and healthcare providers,” agreed Dr. Jean Moorjani, FAAP, a pediatrician at Arnold Palmer Hospital for Children in Florida.
“If parents are having difficulty with helping their teenager develop daily healthy habits, remember that a trusted pediatrician or family physician who has a good ongoing relationship with the family can always be of assistance,” she told Healthline.
“When I am taking care of teenagers, I like to ask them what they would like to become when they get older, or what their goals are in life. As we engage in this discussion, we talk about what we need to do to help reach those goals. In our discussion, we talk about the importance of developing healthy habits today, and how being healthy will help us succeed and reach those goals,” Moorjani said.
Family history a factor
There was a strong family connection with migraines among those surveyed. Ninety-two percent of youth who experienced migraines had mothers with family histories of headaches. With fathers it was 38 percent.
But family history doesn’t doom a child to a lifetime of pain.
“There are a number of good medications,” Jacobs said. “It may take a little trial and error to find the right one.”
Of the children in the study, 131 were girls. Jacobs is not sure why. “Do their parents pay more attention to [subtle] signs in adolescent girls?”
That is one of many questions that remains to be answered.
“I look forward to more research regarding this topic, especially since headache diaries can be useful in monitoring the development of migraines,” Moorjani added. “With more information and research, we will be able to better care for our patients who suffer from migraines.”