About Migraines in Teens

Overview

Migraine headaches in teens are a type of neurological condition that causes moderate to severe localized headaches. These headaches typically occur on one side of the head and can significantly impact a teenager's school, work, and social life. Migraines can be accompanied by additional symptoms such as visual or auditory disturbances, nausea, vomiting, or fatigue. There are several types of migraines that can affect teenagers, including migraine with aura, migraine with brainstem aura, migraine without aura, and abdominal migraine. Migraine attacks in teens can be shorter in duration compared to adults, lasting about 2 hours on average. Chronic daily migraines, characterized by experiencing 15 or more headache days per month for more than 3 months, can also occur in adolescents. It's important for teens experiencing migraines to seek medical attention for proper diagnosis and treatment options.

Causes and Risk Factors

The pathophysiological causes of migraine headaches in teens are not fully understood. The causes are believed to involve temporary changes in chemicals, nerves, and blood vessels within the brain. The brain chemicals, or neurotransmitters, include serotonin and calcitonin gene-related peptide (CGRP). These neurotransmitters play a role in the pain associated with migraine.

As with migraines in adults, migraines in teens are associated with both non-modifiable and modifiable risk factors. Non=modifiable risk factors are factors that a person cannot change or control. Modifiable risk factors are factors that a person potentially can change or control.

Non-modifiable risk factors of migraine headaches in teens include:

Family history: Migraine headaches can be hereditary, with more than 75 percent of people who suffer from migraines having a parent or sibling who also has migraines.
Sex assigned at birth: Teen females are more likely to have migraine headaches than teen males.

Modifiable risk factors of migraine headaches in teens may include:

Stress: Stress is a common trigger of migraine headaches in teens. School, friends, and family problems are common stressors for teens.
Diet: Skipping meals or irregular meal habits may trigger migraines. In addition, certain foods or food additives can trigger migraines in some people. Foods associated with migraines include:
- Meats that contain nitrates, such as hot dogs, sausage, and some lunch meats
- Monosodium glutamate (MSG)-containing foods. Examples include many instant noodles and some chip snack foods.
- Caffeine-containing foods and beverages, including chocolate, coffee, and colas.
- Aged cheeses, including parmesan, cheddar, and gouda cheeses.
Hormones: The normal fluctuation of hormone levels with a menstrual cycle may trigger migraines.
Medications: Oral contraceptives, bronchodilators for asthma, and stimulants for ADHD may trigger migraine attacks.
Medication use/overuse: Excessive use of acute medications for treating migraines can potentially lead to medication overuse headaches.

It is important to note that these risk factors do not guarantee the development of migraines in teens, but they can contribute to an increased likelihood. It is always recommended to consult with a healthcare professional for personalized advice and guidance.

Symptoms

There are four stages of migraine symptoms. Some people may experience some but not all of the stages:

Prodrome is a first warning stage of migraine. During prodrome, a teen may experience fatigue, a stiff neck, or sleep disturbances.
Aura is phase that may occur shortly before the start of a migraine headache. During the aura phase, the teen may see flashing lights or spots or wavy lines, tingling or numbness in the arms or legs, ringing in the ears, or confusion.
Headache is the migraine attack phase. Migraine headaches in teens may last a few hours. During the headache phase, symptoms include:
- Throbbing or pulsing pain in the head. For teens, it often occurs on both sides of the head but may occur on one side of the head.
- Nausea or vomiting
- Sensitivity to light, sound, or strong odors or smoke
- Dizziness
Post-drome symptoms may include feeling exhausted or drained as the migraine headache subsides.

It's important to note that these symptoms can vary from person to person. If your teen is experiencing migraines, it's best to consult with a healthcare professional for an accurate diagnosis and appropriate treatment. They can provide personalized advice based on the specific situation.

Diagnosis

To diagnose migraine headaches in teens, doctors commonly perform the following examinations, tests, and procedures:

Medical examination: The doctor will conduct a thorough physical examination to assess the teen's overall health and look for any signs or symptoms of migraine. A detailed neurologic exam will be performed.
Symptom assessment: The doctor will ask about the teen's symptoms and medical history, including any family history of migraine.
Rule out other conditions: The doctor may order additional tests to rule out other conditions that may be causing the headaches and related symptoms. These tests may include blood tests, electroencephalogram (EEG), imagine with CT scan or MRI scan, and lumbar puncture (spinal tap).

To determine the stage or severity of migraine headaches in teens, additional information may be collected.

Migraine journal: The doctor may ask the teen to keep a migraine journal for a few weeks before the appointment. This journal helps track the frequency, duration, triggers, and relief measures associated with the migraines.
Migraine questionnaire: Doctors may ask the teen to complete a standardized questionnaire about their symptoms and medical history to gain further insight into their migraines.

Remember that these are general procedures, and each case may vary. It is important to consult with a healthcare professional for an accurate diagnosis and appropriate management.

Treatment Options

The goals of treatment for migraine headaches in teens are to alleviate pain, reduce the frequency and severity of attacks, and improve functionality and quality of life. Here are the recommended treatments and how they work to achieve these goals:

Medications:

Pain management: Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help relieve acute migraine pain. For severe migraines, antimigraine prescription medications, such as a triptan, may be prescribed.
Nausea relief: Antinausea drugs may help alleviate symptoms of nausea and vomiting.
For teens who experience frequent migraines (more than once per week), the doctor may recommend medications to help prevent migraines. Medications used to prevent migraines include beta-blockers, antidepressants, antiseizure medications and calcium channel blockers.

Therapies:

Cognitive-behavioral therapy (CBT): CBT helps teens identify triggers, manage stress, and develop coping strategies to reduce the impact of migraines on daily functioning.
Mindfulness-based treatment: This therapy focuses on training teens to be present in the moment, reducing stress and promoting relaxation.

Health behavior changes: Making adjustments to daily routines may help prevent or reduce the frequency of migraine attacks. This includes:

Regular sleep and meals: Maintaining a balanced lifestyle that includes regular sleep and meals can help reduce the recurrence of migraine attacks.
Hydration: Staying adequately hydrated is important for overall health and may also help prevent migraines.
Caffeine consumption: Moderating caffeine intake may be beneficial as excessive consumption can trigger migraines.
Regular physical activity can help prevent migraines by reducing stress levels.
Avoid foods that trigger migraines.

These treatments work together to provide relief from symptoms, reduce the frequency of attacks, improve functionality, and enhance the overall quality of life for teens with migraine headaches. Remember to consult with a healthcare professional for personalized advice.