HEADACHE, MIGRAINE |
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DESCRIPTIONA migraine headache is an intense, incapacitating headache, accompanied by other symptoms, that occurs repeatedly in some children and adults. The blood vessels leading to the scalp and brain plus pain receptors in the brain are involved. Migraine headaches can affect both sexes but are more common in adolescent and adult females.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
SIGNS & SYMPTOMS
The nature of attacks varies between children and from time to time in the same person. Symptoms of a classic migraine attack appear in the following sequence:
Inability to see clearly, followed by seeing bright spots and zig-zag patterns. Visual disturbances may last several minutes or several hours, but they disappear once the headache begins.
Dull, boring pain in the temple that spreads to the entire side of the child's head. Pain becomes intense and throbbing.
Nausea and vomiting.
In other types of migraine attack, the above symptoms (vision disturbances, headache, or vomiting) may be absent, or other symptoms may be present. Some children become pale, with bloodshot eyes and a runny nose or eyes.
CAUSES
Constriction, then dilation and inflammation of blood vessels that go to the child's scalp and brain. Vision disturbances occur when blood vessels narrow. Headache begins when they widen again. Attacks may be triggered by:
Tension. Emotional problems are probably the most common reason for migraine attacks, but headaches don't necessarily coincide with emotional upset. They often occur on weekends, when a child's stress is decreased.
Menstruation.
Fatigue.
Use of contraceptives.
Consumption of alcohol or certain foods.
RISK FACTORS
Stress; family history of migraines; use of many prescription and non-prescription drugs; smoking; excess alcohol consumption.
PREVENTING COMPLICATIONS OR RECURRENCE
See Appendix 19 for suggestions to reduce your child's stress.
An aspirin a day may prevent migraine attacks in older children and adults.
Use of the drug propranolol prevents attacks in some children.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies.
CAT scan (See Glossary) of the head.
POSSIBLE COMPLICATIONSNone expected.
PROBABLE OUTCOME
Your child's symptoms can be controlled with treatment.
TREATMENT
HOME CAREAt the first sign of a migraine attack:
Apply a cold cloth or ice pack to your child's head or splash the child's face with cold water.
Give the child a non-prescription pain reliever, such as aspirin or acetaminophen.
Urge your child to lie down in a quiet, dark room for several hours. The child should try to relax. Listening to music, sleeping, or meditating are suitable activities.
MEDICATION
Your doctor may prescribe:
Antihistamines to expand the child's blood vessels.
Anti-emetics to decrease nausea and vomiting.
Vasoconstrictors to narrow the child's blood vessels.
Pain relievers.
Beta-adrenergic blockers to prevent attacks, if headaches are so frequent or severe that the child can't function normally. The medication may have undesirable side effects and it does not help everyone.
ACTIVITY
Your child should rest during attacks. Between attacks, exercise is desirable to achieve maximum fitness.
DIET & FLUIDS
Because some attacks are caused by foods, such as cheese or chocolate, keep a record of what your child ate before each attack. Your child should avoid foods that seem to trigger migraine attacks. Otherwise, no special diet is necessary.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has a migraine attack that persists longer than 24 hours, despite treatment.
Frequent migraine attacks interfere with the child's normal life.
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