What Are the Symptoms of Migraines in Children?

Pediatric migraine is a common chronic recurrent headache in the pediatric nervous system. Children are mostly 6 to 12 years old. Men are slightly more than women before the age of 10, and adolescent women are higher than men. Its characteristics are: frontal-temporal pain, which is mainly caused by jumping pain, severe pain, or paroxysmal aggravation; the duration of the attack is short, usually lasting 2 to 3 hours, rarely exceeding 12 hours; mostly bilateral headaches, often accompanied by Dizziness, nausea and abdominal pain.

Basic Information

Visiting department: Neurology
Multiple groups: 6-12 years old male child

Common causes: Paroxysmal abnormal response of local intracranial and extravascular vessels to neuro-humoral regulatory mechanisms
Common symptoms: Frontotemporal pain with dizziness, nausea, and abdominal pain

Causes of pediatric migraine

At present, migraine is considered to be a paroxysmal abnormal response to the neuro-humoral regulating mechanism of local intracranial and extravascular blood vessels formed on the basis of genetic qualities, tension, fear, agitation, lack of sleep, climate change, noise, flash stimulation, fatigue, Factors such as cheese and chocolate intake can trigger migraine attacks.

Clinical manifestations of migraine in children

1. No threatened migraine

Recurrent headaches (at least 5 times, and meet the following characteristics): headache duration 1 to 72 hours, headaches accompanied by nausea, vomiting or photophobia, fear of sound, rule out headaches caused by other organic diseases. The nature of the headache is at least two of the following: limited to one side; pulsatile; moderate or severe; aggravated by stairs or other similar daily physical activity.

2. With threatened migraine

Recurrent headaches (at least 2 times, and at least 3 of the following characteristics): one or more fully reversible aura symptoms (presented by focal cerebral cortex and / or brain stem dysfunction), at least one Aura symptoms gradually occur and last more than 4 minutes, or two or more aura symptoms occur continuously, the aura symptoms last less than 60 minutes (if the aura symptoms are more than one, the duration of the symptoms will increase accordingly), and the headache occurs after the aura , And the interval is less than 60 minutes (headaches can occur before or concurrently with aura symptoms).

3. Recurrent vomiting migraine

Recurrent severe nausea and vomiting (at least 5 times, and meet the following characteristics): recurrence, duration of 1 to 5 days, each vomiting attack at least 1 hour, at least 5 vomiting per hour, the symptoms between the episodes completely resolved , At the time of the attack may be accompanied by pale and lethargy, no previous gastrointestinal diseases during physical examination.

4. Recurrent abdominal pain migraine

Recurrent episodes of umbilical or mid-abdominal localized pain (at least 5 times, and meet the following characteristics): Abdominal pain lasts for 1 to 72 hours, with moderate to severe severity, and is dull in nature with nausea, vomiting, At least two of anorexia and pale complexion, no gastrointestinal or kidney disease was found in previous physical examinations, or even those who have suffered from these diseases have been completely controlled.

Pediatric migraine examination

Nervous system examination showed no obvious positive signs. EEG and cerebral blood flow examinations can reveal abnormalities. Skull MRI and CT showed no obvious abnormalities. Severe gastrointestinal symptoms can cause metabolic acidosis, and blood sodium, potassium, chlorine, calcium, and blood pH should be checked.

Pediatric Migraine Diagnosis

Pediatric migraine is currently diagnosed based on clinical symptoms and a positive family history. The diagnosis can rely on the following characteristics: headache, accompanied by abdominal pain, nausea or vomiting. Lateral headache. The nature of headache is beating or pulsating, and tingling. After a short time, it can be completely relieved. Precursors of vision, feeling or movement. One or more members of first-degree relatives have a history of headaches. headache characteristics. If you have more than three of the above items, you can determine the diagnosis of migraine. Organic diseases such as intracranial infection, intracranial mass, and brain trauma need to be ruled out.

Pediatric Migraine Treatment

Drug treatment

(1) Seizure therapy currently used in clinical practice mainly includes non-steroidal anti-inflammatory drugs (ibuprofen), acetaminophen, and 5-HT receptor agonists (triptans).

(2) The most commonly used types of preventive treatment are: ß-receptor blockers (propranolol), 5-HT receptor antagonists (phenothiazine), calcium ion channel blockers (nimodipine , Flunarizine), tricyclic antidepressants (amitriptyline, trazodone), and other drugs that affect monoamine metabolism, anticonvulsants, etc.

2. Non-drug treatment

(1) Biofeedback therapy is a self-regulating method that can reduce the stress response. It is especially suitable for children who need long-term medication due to migraine and can reduce the side effects of long-term medication.

(2) Self-regulation of life stress can effectively reduce the frequency and extent of migraine attacks, relax psychologically, eliminate tension, and increase confidence in fighting the disease.

(3) Good sleeping habits can reduce the onset of migraine.

(4) Diet regulation advocates avoiding as much as possible foods that may induce or aggravate migraine attacks, such as cheese, chocolate, fried products, alcoholic beverages, etc.

(5) Nerve block therapy can block pain stimulation, relieve muscle spasm and vasoconstriction. It is more suitable for children with migraine who are refractory, recurrent, or poorly treated with general medicine. It has the advantages of high headache relief rate and small side effects Is a therapy worth promoting.