Headaches and Migraine
Migraines are a common acute and recurrent headache syndrome in children, characterized by periodic episodes of severe headache accompanied by nausea, vomiting, photophobia (intolerance to light), phonophobia (intolerance to noise), and mood changes or irritability, which is usually relieved with sleep. In children, it may last from 2 to 72 hours, is often bilateral and often occurs without aura.
The diagnosis of migraine in children requires a thoughtful and detailed history, and comprehensive physical examination including examination of the central nervous system (CNS). It is also critically important to exclude any intracranial lesion in an individual child through detail history and physical examination. Although neuroimaging is usually not required in classic migraine, occasionally, an MRI or CT brain scan may be indicated in selective cases.
Management of migraines consists of general lifestyle measures, avoidance of triggers if known, abortive treatment and preventive treatment. Maintaining a headache symptom diary is useful to monitor progress.