Why did vomiting make my migraines worse

Migraines In Children: The Key Facts

How a movie triggered my first migraine attack

When I had my first migraine attack, I was 8 years old. I remember it like today. We were in the cartoon "Piglet's Big Adventure". Already in the middle of the film I noticed how I got a headache.

The stare at the screen, the rapidly changing colorful pictures and the fear when the cute bear Winnie the Pooh was in danger was probably too much for me.

My headache got worse and worse, my head was pounding, I was dizzy, I felt uncomfortable. When the lights came on again in the cinema, I screwed up my eyes, the bright light stinging my eyes. When I got home, my parents immediately put me to bed, but I felt so sick and sick in my stomach that I vomited. The gagging hurt so much. Completely exhausted and exhausted, I finally fell asleep with a cold washcloth on my forehead.

Because, like so many other people affected, I had my first migraine attacks as a child, I want to give this topic its own space to get closer to the unique symptoms, the specific triggers, but also the diagnosis and treatment of migraines in childhood enter into. Because migraines are a challenge even for adults. This is even more difficult for children and adolescents who have only limited control over their everyday lives, and it is no picnic for parents either.

Common migraine symptoms in children: "stomach ache in the head"

Small children (under 5 years of age) cannot always interpret their body signals and correctly assign the symptoms of migraines. It is difficult for them to pinpoint exactly where it hurts. Therefore, children with migraines often describe sensations they already know, such as stomach ache. For this reason, it is particularly important to pay attention to the child's behavior. For example, does it stop in the middle of the game, lie down and withdraw? Does he suddenly feel dizzy and sick? Does it squint its eyes in bright light or cover its ears? Does the child appear tired, restless, is they particularly pale or noticeably red?

Children often perceive the pain during a migraine attack as pressure in the head, they feel sick, they vomit and are sensitive and irritable to noise, smells and light. Movement makes the pain worse. Migraine attacks in children are usually shorter than adults, but otherwise the symptoms are the same. The typical complaints range from a strong one-sided throbbing headache, sensitivity to light, noise, smell, nausea and vomiting, to circulatory problems and possibly occurring neurological failures.

Migraine attacks can also announce themselves with an aura in which visual, speech and perception disorders can occur.

Children who have an aura may have difficulty speaking or see flickering patterns or flashes of light in front of their eyes.

Children who have an aura may have difficulty speaking or see flickering patterns or flashes of light in front of their eyes. There may also be times when their arms and hands become numb and they walk unsteadily.

Another but rare side effect can be Alice in Wonderland Syndrome. Here children see objects or parts of their own body enlarged or reduced; A changed sensation of noise and touch as well as hallucinations are also possible.

Frequency of childhood migraines

In childhood, around 4-5 percent of children have migraines. Girls and boys are affected equally often up to puberty. During puberty, the disease is more common in girls due to hormonal fluctuations and the onset of menstruation. For some, the attacks go away after puberty, but most still have them as adults.

A scientific survey of Dresden schools in which around 5500 pupils from primary and secondary schools were interviewed anonymously showed that more than 36 percent had suffered from headaches on at least one day in the last three months. More than 30 percent of those surveyed had a headache on more than two days a month. At 73 percent, girls suffered more frequently from headaches than boys at around 63 percent. The frequency of headaches increased with increasing age, grade level and type of school.

Among the high school students, the share of headache sufferers was almost 80 percent.

The displeasure of others - or stigmatization in childhood migraines

Almost everyone knows headaches. But migraines are a foreign word for many - especially among children and adolescents. During my puberty I had about 3-4 migraine attacks a month. I liked getting migraines especially after exhausting school days, hot summer days when I didn't drink enough or spent too long in the sun. My friends didn't know the difference between headaches and migraines, and I couldn't really explain it to them at that age either. So it often happened that I met with great misunderstanding when I canceled an appointment or birthday party or went home early from school because of an alleged "slight headache".

So while I was torturing myself at home with the worst pain ever and puking over the bowl, my friends were having fun in the outdoor pool, eating ice cream and enjoying the summer.

But not only did I encounter displeasure among my peers, some of my teachers did not take my chronic illness seriously and smiled at it when I again did not take part in physical education or called in sick again because of "simple headaches". To this day, I sometimes wish that one or the other friend, one or the other teacher would go through a single migraine attack, because then nobody would come up with the idea that I would only simulate the severe pain.

Diagnosing migraines in children

Diagnosing childhood migraines is often difficult and therefore takes many years. Migraines can neither be measured nor seen in a blood count nor seen on an X-ray or MRI. On average, doctors diagnose migraines in children relatively late - around eight years of age.

The doctor's marathon

Because of my migraines, I not only went to the pediatrician and neurologist, but also to the ophthalmologist, dentist, orthodontist, physiotherapist, orthopedist and radiologist.

After I had my first migraine attacks, my parents took me to see a doctor. Since I was old enough to describe my symptoms in detail, my migraines were diagnosed fairly quickly. At the time, I was with a child neurologist who did some tests and advised me to keep a headache diary in order to identify possible triggers. There I should record what happened in the time before the migraine attack, when the migraine started and when it passed again, how severe the pain was, whether I was taking medication - and if so, how well it helped. At that time I was still doing it on paper using analogue methods. Today it's a lot faster because I use the M-sense app to record my attacks and track my triggers.

However, because of my migraines, I not only went to the pediatrician and neurologist, but also to the ophthalmologist, dentist, orthodontist, physiotherapist, orthopedist and radiologist in order to be able to rule out other possible causes of my headaches. Misaligned teeth or jaws, problems with the eyes, muscular tension or blockages can also lead to severe headaches.

Actions and Treatment of Childhood Migraines

Migraines are incurable, neither in children nor in adults. However, there are some treatments that can significantly reduce the frequency and severity of attacks.

In children in particular, the causes can often be found in everyday life. Whether an irregular daily routine, irregular meals, stress and pressure to perform or a lack of exercise, all of these factors can promote migraine attacks. In order to find out which triggers, i.e. triggers, prevail in the respective child, keeping a migraine diary can be used. A lot can be achieved with a regular daily routine, regular meal times, a balanced sleep-wake cycle, regular exercise and the avoidance of psychological and physical stress.

According to the migraine guidelines of the German Society for Neurology, a document on the therapy of migraine attacks and prophylaxis of migraines, the effectiveness of drug-based migraine prophylaxis in children has not been conclusively proven. That is why drug measures are not to be given preference. In the following paragraphs, I will use this guide as a guide, as it is based on high-quality clinical studies and was created by specialist doctors.

Migraine prophylaxis in children and adolescents

Certain relaxation methods are very suitable for reducing stress-related migraine attacks.

The most widespread is the so-called progressive muscle relaxation (muscle relaxation) and autogenic training. With both methods, it is of crucial importance that they are used regularly, ideally daily, so that success can be achieved.

Food supplements and prophylactic drugs such as high-dose magnesium, vitamin B12 or coenzyme Q10 can also be considered. The exact dosages must of course also be discussed with the doctor. However, in a double-blind, placebo-controlled study on children and adolescents, coenzyme Q10 could not be shown to be superior to placebo [1, DVG Guide].

For many children, calm, darkness and a cool cloth on the forehead and neck already provide a little relief.

A massage or acupressure of the temples as well as essential oils with peppermint and eucalyptus can potentially make the pain more bearable. However, caution is advised with essential oils, as not every child can tolerate them and perceives the smell as pleasant.

Acute treatment of migraine attacks in children

Pain relievers in children

In the event of acute attacks, children can also use pain relievers such as paracetamol or ibuprofen. However, it should be discussed in advance with the pediatrician whether and in what dose and dosage form the medication should be taken. Suppositories, for example, work much faster than pain killers due to the shorter absorption time of the active ingredients. Stronger active ingredients or preventive agents must be discussed with the pediatrician and the treating neurologist and must never be given to children without medical advice.

A survey of Dresden schools showed that ibuprofen was taken the most frequently with almost 50 percent. Of the affected schoolchildren who had headaches for more than two days a month, more than half named pain relievers for their symptoms. Shockingly, the survey showed that just 20 percent of those afflicted with headaches consulted a doctor to discuss the treatment of their symptoms.

Triptans? For children too?

Sumatriptan 10 mg and zolmitriptan 5 mg are approved as nasal sprays for the treatment of migraines in adolescents from the age of 12. In triptan studies, the high placebo response and the short duration of the attack were methodological problems for demonstrating a good effect of the triptans in children under 12 years of age.

Sufficient data are now available to support the use of triptans (sumatriptan 10–20 mg as a nasal spray, zolmitriptan 2.5–5 mg tablets, rizatriptan 5–10 mg tablets and almotriptan 12.5 mg tablets) in the event of an inadequate response to acute analgesic therapy ) to justify with appropriate information [2, DVG guidelines].

If the child has migraines, the parents suffer too

For my parents it was and is still very difficult to bear to see myself suffering so much from a migraine attack. You feel helpless and overwhelmed and would love to relieve me of my pain.

Over the years they have learned that they can "help" me best during an attack if they avoid noise, do without vacuuming and cleaning the dishwasher, if they give me the opportunity to retreat and in between wetting my washcloth again.

It's best at home for children with migraines

Parents of children with migraines should organize and adjust their diaries as much as possible so that the child has enough time to play and relax freely. Instead, parents can ensure that the child does not spend too much time in front of the television or computer, that they have a balance to the stressful everyday school life and that they do not put any additional pressure on their child to perform. It is also important that children find a kind of shelter in their parents' home, in which they can freely and openly talk about their fears, worries and thoughts and experience a lot of care and calm.