Male1: Sometimes kids get headaches and the doctor says, you have got a migraine headache. What is a migraine headache and how come he is so sure?
Male2: Yes, migraine headaches are actually more common in children than a lot of people think. A lot of children complain of headaches once in a while and the parents will often attribute this to the child sort of just complaining like trying to avoid going to school or going to bed, but a lot of times, these are migraine headaches, and a good neurologist or a headache specialist who have been able to talk to the child and find out exactly what the symptoms are.
Male1: What would you be looking for?
Male2: So some classical things that we see in migraine are, in children, it is a little bit different than in adults, although we will see that they will complain of the headache being in the front or on the sides of the head. Sometimes, they are on one side more than the other. A lot of times, they will be bothered by bright lights or loud noises, but a lot of these children—and also associated with being dizzy or nauseous, sometimes even vomiting with the headaches, and a lot of these children actually have significant motion sickness when they get car sick and this is actually related to the migraines.
Male1: Are there any attributes—lack of sleep, certain foods? Any triggers associated?
Male2: Yes, there are a lot of triggers of migraines that can make migraines more frequent or more severe. And this is something that we see all the time where a child will be having migraines for years and only about once a month or twice a month to someone, once they start having more of these triggers in their life, they will start having more frequent and more severe headaches and that is when they will come to the neurologist.
Male1: A common trigger is lack of sleep too?
Male2: So lack of sleep, going to bed late or even just having erratic sleep schedules is definitely one of the more common ones; skipping meals, so skipping breakfast is very common. In children, we see a lot today of having too much caffeine, while caffeine can actually treat a migraine at small doses, but what happens is that if you have a regular intake of caffeine in the form of iced tea, chocolate, chocolate milk, coffee, sodas with caffeine, when that is out of your system, your body actually craves and you end up having a migraine from that; monosodium glutamate is common in Chinese food and instant soups and then we have nitrates like in hotdogs and cold cuts, all these things are triggers for migraine.
Male1: So we should like a log if you see the kid ate something and then the kid got sick with the migraine, you might look at what the kid ate and maybe it is the trigger.
Male2: Yes, and sometimes it is hard to associate because you might not get the headache until the next day, but if you are having any food—any food that you are having in excess of this can definitely exacerbate the migraines.
Male1: I was told to keep a log and those maybe school days?
Male2: Exactly.
Male1: We they have a test, they get the migraine, the stress of it too—so if you look at that, maybe it is not school days.
Male2: Yes and keeping account is very important. We get to see the frequency and the response to the treatment and that helps us in deciding how to properly manage it.
Male1: And the common over the counter medicines, are any of them really helpful with headaches?
Male2: So some do. The better ones are really like the medications like Motrin or Aleve. Those work better than some of the other analgesics. One of the other problems is that a lot of patients start having frequent headaches and the parents keep giving them medications like Tylenol or Aspirin and the more headaches they have, the more medicine they give them and they get to a point where they are having medication four times a week and that can actually trigger headaches from over use of the medication.
Male1: One side effect listed against ibuprofen which is Advil and Motrin can be a headache?
Male2: Yes, exactly.
Male1: So you have to take that in consideration.
Male2: Right and that is why it is important to see a neurologist to get treatment properly. If they are not seen properly, usually, what ends up happening is, they will become more frequent and more severe and then they just become more and more difficult to treat.
Male1: What will be the drug of choice then for an adolescent because the issue of what he would pick, outside of using over the counter?
Male2: Yes, I mean after the Motrin, if that is not working, one of the medications that should work a little bit better is something called Naprosyn which is similar to Aleve. That happens to work better than that, and that will usually do the trick. If that is not working, then it will depend on the age group and the type of headache that they are having, or we can move on to other medications such as Triptans would be the next choice to start with as far as a therapy trying to stop the actual headache.
Male1: The trick here is not something rash—so there are drugs that actually you can take if you have a migraine.
Male2: Sure.
Male1: Old or adolescent.
Male2: And you really should do that. I mean, a lot of parents still want to give their children medication, which they obviously understand, but what happens is when they start missing school and having difficulty concentrating, it is really going to affect their life and cause them pain that is not necessary.
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