Q: My son seems to be suffering from more and more headaches lately. How can you tell the difference between a headache and a migraine, and when should you see a doctor?

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A: The first thing to know is that the term headache covers a wide range of conditions, and headache itself is a symptom that has many different potential causes

A: The first thing to know is that the term headache covers a wide range of conditions, and headache itself is a symptom that has many different potential causes

A migraine is one cause of headaches and it has a very specific description and manifestation.

The most important feature of a migraine is that it is a chronic condition; it doesn’t just happen once or twice. The second big feature of migraine headache is that it happens repetitively but over brief period of time, generally less than a few hours. In some rare cases it can last three days.

Some people are surprised to learn that approximately 20 per cent of children and adolescents have migraines. Generally speaking, the earliest age to start having migraines is four years old but they are sometimes diagnosed in children as young as two.

An important distinguishing feature about migraines is the presence of a sequence of symptoms, which include more than just a headache. Usually, the first symptoms start in the eyes when the person sees little bright or black spots or moving lines. Sometimes they will also feel stomach pain or nausea. The headache then starts within seconds or minutes and quickly reaches a very uncomfortable level. At that point, it is difficult to function normally: concentration and basic functions such as walking or talking become impossible. People experiencing a migraine also tend to avoid light and noise since these can increase the pain. Most people—even children—just want to go to bed with the lights off and the curtains drawn.

So it’s important to look for this sequence of symptoms to help determine if your child has migraines. Also, your child needs to experience the sequence of symptoms five separate times to be diagnosed with migraines.

Much of what you and your child’s doctor need to know can be determined by simply asking questions. An interesting—and often reassuring fact about diagnosing migraines is that no tests such as CT scans or MRIs are needed. There is also a genetic component to migraines but it doesn’t mean your child will need genetic testing. Parents don’t always make the link between their own migraine headaches and their child’s headaches and just a simple question from the doctor can help make this link.

There are very effective medications and treatments for migraines which have made living with the condition much better than in the past. If you think your child might be suffering from migraines, talk to your pediatrician or family physician. They’ll help you determine the diagnosis and decide on the best treatment options.

Montreal Children's Hospital
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Neurology and Neurophysiology

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