Migraine Headaches

Migraine headaches have made the news recently.  Migraines are a specific type of so called “vascular “headache.  This is because migraines occur when arteries around (not IN) the brain first becoming constricted and then becoming grossly dilated.  This is what causes the terrible pounding sensation.  Typically the pounding pain occurs on one side of the head (“heMICRANIUM”–half the head–source of the word “migraine”).  The pain usually resolves after a few hours but can rarely last for days.

Other symptoms associated with migraines:

  • nausea and vomiting
  • dizziness
  • neck pain
  • light hurting eyes (“photophobia”)

Migraines do not cause cause fever, rashes, or cough/respiratory symptoms (although they may rarely result from sinus infection).  Frequently recurring episodes, confusion, severe lethargy, or sleepiness are very rare.  If your child has these symptoms associated with migraines you should have this investigated.

A scientifically interesting, if emotionally disturbing, pre-symptom of migraine is the  prodrome “aura.” During the early artery constriction phase of the process people may often experience strange sensations like seeing flashing lights or zig zag lines, smelling strange odors, or sometimes very odd behavior phenomena.  

There are many things we can do to treat or prevent migraines:

  1. Limit stress wherever possible–don’t over schedule your child’s life
  2. Adequate rest–adolescents need >8 hours of sleep.  Naps are helpful but do not replace a full night’s sleep
  3. Regular meals–especially breakfast
  4.  Limit eye strain–get those cell phones, tablets, computers, video games out of the child’s bedroom
  5. Use the “prodrome”–analgesics like acetaminophen or ibuprofen can be very effective if administered early on.  The severe migraine can often be prevented by identifying “prodromal” symptoms, taking above medicines, and resting in a dark, quiet room with a cool compress on the child’s head for 20-30′.
  6. Anti-nausea medicines like promethazine (“phenergen”) or ondansetron (“zofran”) can ease those symptoms
  7. For frequent or severe migraines (>weekly occurrences) we frequently employ a number of daily “maintenance” medications.  However, recent studies raises serious doubts about the efficacy of this approach, so we should consider these medications carefully in light of this new evidence.

Please contact me with questions about headache and migraines in your child; and thanks for following.



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