Migraine in Childhood: What Pediatric Migraine Looks Like and How to Help

Kids can have migraine but may experience it differently than adults. Here’s everything you need to know about migraine in children, including what it looks like and how you can help.

Migraine is a condition that affects adults and kids. But depending on age, it doesn’t always look the same.

Migraine can manifest differently in kids, which can sometimes make it harder to identify, diagnose, and treat.

Here’s what you need to know about migraine in kids, including symptoms, treatment options, and what you can do to help your child with migraine.

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How common is pediatric migraine?

Migraine in kids is more common than you may think. In fact, it’s the most common primary headache disorder in kids and teens.

Nearly 1 in 10 kids in the United States have migraine. Up to 18%, or nearly 1 in 5, of pediatric visits to the emergency room are migraine-related.

Migraine becomes more common as kids get older. Around 15% of teens, or nearly 1 in 7, experience migraine.

Why do children develop migraine?

One of the main causes of pediatric migraine is genetics. If one or both parents have migraine, there’s a 50% to 75% chance their child will have it, too.

However, children whose parents don’t have migraine can also develop it. These kids may develop migraine on average 2 to 3 years later in childhood or adolescence than those whose parents have migraine.

Most children have spontaneous attacks, meaning attacks occur without a particular trigger.

In kids who do have migraine triggers, they’re often similar to adults.

Migraine triggers can include:

• stress
• sleeping too much or too little
• certain foods
• skipping meals
• weather changes
• dehydration

What are the symptoms of pediatric migraine?

Migraine may not present in the same way in kids as it does in adults.

Like adults, some kids experience attacks in stages. Research estimates about one-third of young kids and two-thirds of older kids and teens with migraine may experience a prodrome stage.

Symptoms can include:

• loss of color in the face
• fatigue
• irritability
• mood changes
• yawning

For those who have an aura stage, there may be one of several types of aura, or sensory disturbances:

• Visual aura is the most common form in kids. It includes visual disturbances like bright spots, lines, or blind spots.
• Sensory aura sometimes accompanies visual disturbances and can present as numbness or tingling.
• Speech aura involving slurred speech can also occur, though more rarely.
• Motor aura, like weakness or muscle fatigue, is rarer. Certain types may be a sign of a rare form of migraine called familial hemiplegic migraine.

Then there’s the migraine attack stage. This is where pediatric migraine can differ most from adult migraine.

Headache pain is typically not the primary symptom of pediatric migraine. For kids who do experience headache pain, it’s different than in adults.

While migraine pain in adults tends to be one-sided, it’s generally bilateral, or felt on both sides, in kids. Kids also often experience pain in the front of the head.

Other symptoms can include:

• nausea
• vomiting
• sensitivity to light
• sensitivity to sound

Younger kids may also frequently experience these attack symptoms:

• loss of color in the face
• loss of appetite
• difficulty thinking
• lightheadedness
• fatigue

In older kids and teens, migraine symptoms can also include sensitivity to smell.

What is abdominal migraine?

Some kids may experience pediatric migraine as abdominal migraine.

Abdominal migraine affects around 4% of kids with migraine, making it one of the most common types of pediatric migraine. This form can sometimes be confused with gastrointestinal tract disorders.

Symptoms of abdominal migraine include:

• moderate to severe stomach pain
• nausea
• vomiting
• loss of color in the face
• loss of appetite

Abdominal migraine pain is sometimes described as centered around the belly button and pain all over. Headache pain is not a symptom of abdominal migraine.

Attacks can last anywhere from 2 to 72 hours, with the average duration being 17 hours, research estimates. There are no symptoms between attacks.

While abdominal migraine is mainly a childhood form of the condition, adults can also experience it.

How is pediatric migraine diagnosed?

Like migraine in adults, pediatric migraine is diagnosed based on the child’s individual and family medical history.

Try to keep track of everything you suspect may be associated with migraine in a symptom diary. You can give it to your child’s care team to provide the most detailed picture of what’s happening.

Note things like:

• frequency of attacks
• duration of attacks
• symptoms you notice or that your child shares with you
• potential triggers
• tools, activities, or medications that provide relief

Additional testing, like MRI scans or other imaging procedures, may be necessary in certain cases to rule out other conditions.

Are there kid-safe migraine treatment options?

Migraine in kids can be scary and upsetting, but just like for adults, there are many treatment options available.

Both nonmedical and medical options exist, some of which overlap with adult migraine care.

Nonmedical treatments for pediatric migraine include:

• practicing good sleep hygiene
• maintaining a regular meal schedule without skipping meals
• adapting diet as needed
• staying hydrated
• exercising and moving regularly
• managing stress

In some cases, medical options may be recommended. Whether medication is right for your child depends on how severe their migraine is and how much it interferes with daily life, like going to school or playing.

For medication that can be taken during an attack, options include:

• over-the-counter medication, like ibuprofen or naproxen
• prescription medication, like triptans
• anti-nausea medication

For children who have frequent attacks, your child’s doctor may prescribe preventive migraine medication for regular use. These options are a more serious step. Your child’s doctor can discuss the benefits and downsides of preventive medication with you.

Finding the right treatment regimen for your child can be a collaborative process between you and your child’s pediatrician or neurologist.

Will kids with migraine have migraine later in life?

Pediatric migraine can often be an indicator of migraine in adult life. Up to 75% of kids with migraine will also experience migraine as adults.

At least 66% of kids with migraine respond well to treatment, and those who do are likely to also respond well to treatment in adulthood.

Tips for how to help manage migraine in kids

Here are a few tips for managing migraine in kids.

Identify and avoid triggers

If your child experiences migraine triggers (not all do), try to keep track of what seems to bring on symptoms. Maybe it’s certain foods, disruptions to sleep patterns, or increased stress.

Then, avoid those triggers as much as possible.

Maintain a regular schedule

Creating a routine may help minimize migraine triggers.

Set and stick to bedtimes and wake-up times along with regular mealtimes. Place limits and breaks on screen time, and generally manage stress in the home.

Keep your child’s school in the loop

Inform the school that your child has migraine, with a doctor’s note if necessary. Put a plan in place for what your child should do if they start experiencing symptoms at school, like leaving class to rest in the school nurse’s office.

Encourage rest during episodes at home

If possible, have your child rest or sleep in a dark, quiet room with a migraine first aid kit close at hand during an attack.

Your child’s doctor can also help you figure out the best ways to manage, prevent, and treat your child’s migraine.

The takeaway

Just like adults, kids can have migraine, too.

Pediatric migraine can present differently than adult migraine, partly because headache pain is not one of the primary symptoms. Kids with migraine often experience nausea, vomiting, and abdominal pain, as in abdominal migraine.

By working with your child’s care team, you and your family can figure out the best way to help your kiddo thrive while managing migraine.