Children, Migraines, and Risk Factors

Unfortunately, adults are not the the only known group of migraine patients. Children are among the migraines patients that doctors tend to as well. However, early recognition of migraine risk factors may help a child to adopt a healthy lifestyle and manage the occurrence and symptoms of migraines.

Familial aspects
The familial occurrence of migraine has been recognized for many years. The significantly higher concordance rate among twins supports a strong genetic basis for this condition.

Hormonal changes
Hormonal changes also appear to play a role. Prior to puberty, migraine occurs equally among boys and girls. With the onset of puberty, migraine becomes significantly more common among females.

Foods
Dietary triggers may also provoke a migraine attack. Helping the child learn to recognize and avoid these triggers is helpful but often difficult. A headache diary can be useful for identifying triggers; a pattern often emerges after 6-8 weeks. Note that some patients inappropriately use the diary to create restrictive diets that could harm normal growth and development.

Beverages
Alcoholic beverages, especially red wine, and an excess or a withdrawal of caffeinated drinks, such as coffee, tea, cocoa, or colas, may trigger a migraine headache. The patient should limit caffeinated sources to no more than 2 cups per day to prevent caffeine-withdrawal headaches. Some migraine headaches may be triggered by artificial sweeteners (eg, aspartame) in diet sodas.

Medications
Over-the-counter (OTC) and prescription medications can trigger or exacerbate migraines. Excessive use of OTC pain medications and analgesics can cause occasional migraine attacks to convert to analgesic-abuse headaches or drug-induced refractory headaches. Also, migraine patients who have undergone prolonged prescription drug treatment to avoid a sudden withdrawal from these medications, because migraine headaches may result.

Psychological, Physiologic, and Environmental Triggers
Additionally, migraine attacks can occur as a result of psychological, physiologic, or environmental triggers. Psychological triggers include stress, anxiety, worry, depression, and grieving. The frequency of migraines can be reduced by maintaining a healthy lifestyle, but it cannot be eliminated. Physiologic triggers include fever or illness, fasting, missing a meal, fatigue, and sleep deprivation. Encourage children with migraine attacks to maintain a routine with regular meal times and adequate sleep.

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