Migraine can be a debilitating condition for teenagers, and they should be taken seriously. Symptoms can include pain in the head area, sensitivity to light and sound, and dizziness, among others.
When Lyz Lenz got her first migraine headache at age 17, her doctor’s failure to take her seriously was almost as crushing as the pain itself.
“It was horrible and scary,” Lenz says. “No one believed how bad it hurt. I was told it was my period.”
When Lenz sought emergency medical care, she still couldn’t get a proper diagnosis.
“When my mom finally took me to the ER, the doctors were convinced I was on drugs,” she says. “Almost every doctor until my current one had me chart my periods and my migraines. There was never a correlation.”
Now in her 30s, Lenz says she has her migraine headaches under control.
Diane Selkirk experienced something similar with her doctors. She says they thought epilepsy was at the root of her headaches. “I used to bang my head on the crib,” she says. “My parents were told kids don’t get headaches.”
Selkirk was later put under the care of a doctor who also experienced migraine. She was finally diagnosed around age 11.
Still, they took a toll in her teen years, causing her to miss school and social activities. “If I got overly excited or stressed, I tended to get a headache and often ended up vomiting,” she recalls. “I also had trouble with dances and plays, because the lights tended to trigger me.”
Lenz and Selkirk aren’t alone in having migraine as teenagers and having trouble getting diagnosed. Learn why this is and how you can help your teenager get the help they may need.
“Migraine headaches can impact school performance and attendance, social and family interactions, and quality of life in general,” says Eric Bastings, MD, deputy director of the Division of Neurology Products in the U. S. Food and Drug Administration’s Center for Drug Evaluation and Research.
According to the Migraine Research Foundation, up to 10% of school-aged children and 28% of teens are affected by migraine.
“It’s important that people realize that children and adolescents have migraine,” says Amy Gelfand, MD, a pediatric neurologist at the University of California, San Francisco Headache Center. “It’s one of the more common problems for children.”
She continues, “There’s a lot of stigma around children and migraine. People think they’re faking, but for some children and adolescents, it can be quite a disabling problem.”
Before puberty, migraine may be more common in males than in females. During puberty, migraine may be more common in females than in males.
“It is fairly common for migraine to begin in puberty,” Gelfand says. “A migraine [attack] can be activated any time there’s a lot of change going on.”
Eileen Donovan-Kranz says that her daughter had her first migraine attack when she was in eighth grade. She says her daughter spent much of her time after school lying down in her room.
“We were able to put her on a 504 plan for school, but individual teachers were not always helpful,” Donovan-Kranz says. “Because she was well much of the time, and very out of it or sick and in pain at other times, she was sometimes penalized for inconsistency.”
Her daughter is now 20 years old. Although her migraine attacks have decreased in frequency, they still occur.
For children and teens, symptoms of migraine can include:
- sensitivity to light and sound
- pain in the head, behind the eyes, or in the neck
- stomach upset
- nausea or vomiting
- mood changes or irritability
- dry or red eyes
- dizziness
- lightheadness
- scalp tenderness
- difficulty concentrating
Children and teens may also experience migraine with aura, which can include the following additional symptoms:
- weakness
- numbness or tingling
- speech difficulties
- slurred speech
- visual distortions
Although researchers haven’t figured out what exactly causes migraine, they’ve identified several potential triggers.
The most common triggers can include:
- inadequate or altered sleep
- skipping meals
- stress
- hot weather
- bright lights
- poor posture
- dehydration
- lack of exercise
- caffeine use
- menstrual hormone changes
- depression
- life changes
- alcohol
- foods with food coloring, nitrates, or certain additives or preservatives
Keep a symptom journal
Ask your teen to record the frequency and intensity of their migraine symptoms in a journal. They should note what they were doing when the migraine attack started. By observing their surroundings or current behavior, they may be able to identify patterns or triggers.
Your teen should also track any supplements and medications that they take. These may contain inactive ingredients that can trigger migraine.
There is a 50% chance that a person will develop migraine if a first-degree relative, such as a parent, has the condition. It’s estimated that if both parents have migraine, a child’s likelihood of having it will be around 75%.
Thus, your family history may be able to help your doctor make a diagnosis.
Additionally, a
Before diagnosing migraine, your doctor will perform a full physical and neurological exam. This includes checking your teen’s:
- vision
- coordination
- reflexes
- sensations
You should also encourage your child to keep a symptom journal, as described above. This can be helpful, as the doctor will want to know:
- a description of the pain, including the location, nature, and timing
- the severity
- the frequency and duration of episodes
- identifiable triggers
Selkirk’s daughter Maia, 14, started getting migraine headaches at the onset of puberty. Selkirk says she was able to help her daughter by recognizing early symptoms and treating them based on her own experience.
“When she gets a migraine, I give her an electrolyte drink, put her feet in hot water, and ice the back of her neck,” she says. Although this isn’t a medically recognized treatment, she says it’s helpful.
If this doesn’t help, she says Maia will take an Advil and lay down in the dark until she feels better.
“I think having a variety of tricks and skills does really help,” Selkirk says. “I’ve learned not to let a migraine get entrenched but to deal with it as soon as the first symptoms start to appear.”
Over-the-counter pain relievers
Over-the counter pain medications usually work for milder migraine pain. These include nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Motrin) and pain relievers such as acetaminophen (Tylenol).
Prescription pain medications
In 2014, the FDA approved topiramate (Topamax) for the prevention of migraine headaches in adolescents ages 12 to 17. This is the first FDA-approved drug for migraine prevention in this age group.
Gelfand says the following triptans are approved for children and adolescents:
- almotriptan (Axert) for ages 12-17
- rizatriptan (Maxalt) for ages 6-17
- zolmitriptan (Zomig) nasal spray for ages 12-17
- sumatriptan/naproxen sodium (Treximet) for ages 12-17
You’ll need to weigh the side effects of these drugs when discussing them with your doctor.
Biofeedback
Biofeedback involves learning how to monitor and control the body’s responses to stress, such as lowering heart rate and easing muscle tension.
Self-awareness at this age can be beneficial throughout life, beyond managing migraine.
Counseling can also help if you think your teen’s migraine attacks are accompanied by depression or anxiety.
The best way to prevent a migraine from becoming severe is to take your migraine medication when symptoms begin.
You can also talk with your teen about the pitfalls of overscheduling, which creates pressure and cuts into sleep. Keeping a regular sleep schedule, getting regular exercise, and eating regular meals without skipping breakfast can help prevent migraine headaches.