SingaporeMotherhood | Preschooler & Up

April 2016

Migraine In Kids – When that Headache is more than just an ache

Your kids can give you headches, but did you know that children can get them too? In fact, children can even get migraines. Migraine is “very common in children”, Dr Mohammad Tauqueer Ahmad, a Specialist in Neurology and Consultant at Raffles Neuroscience Centre, tells us. He adds that it affects eight per cent of school-age children in Singapore (and 10 per cent globally).

And there’s a reason why it’s a common condition in children. Dr Phuah Huan Kee, a Paediatric Neurologist at Mount Elizabeth Hospital, tells us that the ‘pain control centres’ in children who get migraines is set at a lower threshold compared to other individuals. As a result, he says, “They are very susceptible to ‘irritation’ from environmental and emotional triggers (e.g. food, smells, noises, stress), which will cause the pain control centre to ‘misfire’, leading to disturbed cerebral brain activities that eventually cause migraine headaches.”


How is a Migraine Different from a Headache?

Is a migraine just a really bad headache? Not at all, says Dr Ahmad. In fact, it is a neurological disease. Migraines are accompanied by associated symptoms such as nausea, vomiting, dizziness, sensitivity to touch, sound, light and odors, abdominal pain, and mood changes.

All in all, migraine can be as debilitating to a child as it is to an adult.

“While children generally have fewer and shorter migraine attacks than adult sufferers, childhood migraine can be just as disabling, and it can seriously affect the child’s quality of life,” Dr Ahmad adds.

What you Need to Know about Migraine in Children


Dr Phuah gives us the low-down:

• Younger children may experience migraines. However, since migraine is a clinical diagnosis, they are often diagnosed only among older children, aged over five years.

• Younger infants and toddlers may have episodes with symptoms such as paroxysmal vertigo/unsteady gait (ataxia). These may be a precursor for migraines in the future.

• Among children less than seven years of age, migraines are more common in boys.

• Among children aged between seven and 11 years, migraines are equally common in both boys and girls.

• In adolescents, migraines affect girls more than boys.

• About 40 to 50 per cent of children with migraines (more boys than girls) outgrow their migraines by 25 years of age .

• In about 10 per cent of cases, the migraine triggers (e.g. certain foods/odour, loud noises, sleep deprivation, stress) can be identified. By avoiding those triggers, the occurrence of migraines may be minimised.

What causes Migraine in Children?


Potential migraine triggers include excessive caffeine (probably not for children!), skipping meals (hunger) and dehydration. Food can sometimes trigger a migraine too.

“Food triggers may be present in about 10 per cent of cases and are different in each child. Hence it may be prudent to keep a headache diary and look through what the possible food items (e.g. caffeine, MSG, nuts) that are linked to migraines are, followed by a food elimination of each suspected item to see if it helps to minimise the occurrence of migraines,” suggests Dr Phuah.

If migraines occur frequently (more than once per week) and disrupt to your child’s routine activities and schoolwork, it’s time to have a discussion with your doctor about preventive medicine. This has to be taken daily to minimise the occurrence and lessen the intensity of migraines for three to six months.

Does my Child have Migraine?

Migraine can be tricky to diagnose. Young children under the age of five years may not be able to adequately describe the nature of their headaches and its associated symptoms (like visual disturbances and vertigo). So it is common for migraines to be under-diagnosed in young children or mistaken for stomach flu until the child is old enough to describe the symptoms (in addition to the vomitting they have been experiencing previously).

Ask your child where the pain is. In children, migraines are usually bilateral. This means they affect both sides of the head, over the frontal or temporal regions.

Note how long the pain lasts. In children, migraines are shorter in duration. They last between two and 72 hours, compared to adults (who generally experience migraines on one side of the head for four to 72 hours).

Headaches that are part of migraine occur in episodes. These can happen either sporadically (e.g. once a few months) or very frequently (e.g. once every two to three days).

“In most cases,” says Dr Phuah, “the diagnosis can be made after gathering a detailed history from the parents regarding the nature of headaches and its associated signs or symptoms. We can also perform a clinical examination or brain scans to look out for red flags or sinister causes of headaches (for example, brain tumors and intracranial bleeding).”

What should I do if my Child has a Migraine?

Those nuts in his breakfast cereal could be causing his migraine

If your child has been diagnosed with migraine, you should inform his school and his teacher. “Children with mild or moderate migraine attacks may respond to early administration of painkiller (paracetamol or ibuprofen). This may shorten the duration and lessen the intensity of pain,” says Dr Phuah.

“Should a child experience a migraine attack in school, the school nurse may administer a dose of painkiller (as recommended by the doctor) and let the child rest in a quiet area. If he has photophobia (sensitivity to light), you can darken the room for him. Children with migraines can participate in regular exercises as long as they can tolerate them, when they are symptom free,” he adds.

The best way help your child lead a migraine-free life is to find the main migraine triggers and avoid them, adds Dr Ahmad. Also, try to ensure that your child gets proper food and sleep, avoids late-night activities, and maintains a healthy lifestyle, he says.


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Migraine In Kids – When that Headache is more than just an ache