1. Headache Clinic
Treatment – and beyond
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Common Types of
Migraine Headaches
and Symptoms:
What Kind Does Your
Child Have?

2. Headache Clinic
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Abdominal Migraine
Abdominal Migraine
Abdominal migraine affects mainly children between 5 and 9 years of age. Many of these children go
on to develop migraine headaches (with or without aura) later in life.

3. Headache Clinic
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What Are the Symptoms
of Abdominal Migraine?
Abdominal Migraine
Symptoms may include:
• Midline abdominal pain of moderate to severe intensity that lasts 1 – 72 hours
• Chronic or recurring pain severe enough to interfere with normal activities
• Mild or no headache
• Nausea, vomiting, loss of appetite
• Pallor with dark shadows under the eyes or flushing
• The absence of another illness, including a gastrointestinal disorder

4. Headache Clinic
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How Is Abdominal Migraine Diagnosed?
Abdominal Migraine
No specific diagnostic test is available to confirm abdominal migraine. A diagnosis is made through
a thorough evaluation of the patient’s medical history, incidence of migraine headache in the family,
symptoms, and a physical exam and tests to rule out other conditions.

5. Headache Clinic
Treatment – and beyond
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What Are the Treatment Options
for Abdominal Migraine?
Abdominal Migraine
For children and teens, abdominal migraine treatment includes rest, plenty of fluids, over-the-
counter pain relievers and relaxation/behavioral therapy techniques. For older children and adults
with infrequent abdominal migraine attacks, physicians may prescribe medications used for other
forms of migraine, such as NSAIDs, anti-nausea medication and triptans. Frequent abdominal
migraines are treated with the same preventive therapies used for other migraines.

6. Headache Clinic
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Migraine Headache
Migraine Headache
The average age of onset for migraine is 7 years old for boys and 10 years old for girls, although
symptoms may appear in much younger children. Up to age 12, equal numbers of boys and girls
suffer from migraine; by the ages 21 – 24, up to 80% of migraineurs are women. Children with
migraine often have a family history of migraine. Migraine affects up to 5% of school-aged children.
From 50% to 75% of children with migraine will cease having attacks between adolescence and
early adulthood, but some will redevelop migraine later.

7. Headache Clinic
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What Are the Symptoms
of Migraine Headache?
Migraine Headache
Common symptoms of migraine in youngsters include:
• Pain on one or both sides of the head, or a child
may report pain “all over”
• Pounding or throbbing pain, although children
may not be able to articulate this
• Abdominal upset, nausea and/or vomiting
• Sensitivity to light and/or sound
• Sweating
• Becoming pale or quiet
• Experiencing an aura, or a sense of flashing
lights, funny smells and changes in vision

8. Headache Clinic
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Tension-Type Headache
Tension-Type Headache
This common headache type is triggered by stress or emotional/mental conflict.

9. Headache Clinic
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What Are the Symptoms
of Tension-Type Headache?
Tension-Type Headache
Generally, symptoms include:
• Headache that develops slowly
• Pain usually present on both sides, and may involve the back of the head
• Dull pain or pain that feels like a band around the head
• Mild to moderate, not severe, pain
• Change in sleep habits

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Cluster Headache
Cluster Headache
More common in adolescent males, cluster headache usually begins in children over 10 years of age.
This headache type occurs in a series, or “cluster,” that can last for weeks or months. This series of
headaches may recur annually or every other year.

11. Headache Clinic
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What Are the Symptoms
of Cluster Headache?
Cluster Headache
Common symptoms in children and adolescents include:
• Unilateral (one-sided) pain, often behind an eye
• The affected eye may look droopy and have a small pupil, or the eyelid may be red and swollen.
• Congestion or runny nose
• Swollen forehead

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Headache Associated With a Serious Issue
Headache Associated With a Serious Issue
If your child shows these symptoms, consult a headache specialist to determine if there is a possible serious
underlying cause:
• Headache in a very young child
• Headache pain that awakens a child
• Headaches that begin very early in the day
• Pain worsened by strain like a cough or sneeze
• Recurrent vomiting episodes or other signs
of a stomach virus
• Child complaining about “the worst headache ever”
• Increasing severity of headache, or one that
continues
• Personality changes
• Weakness in limbs or problems with balance
• Seizures or epilepsy

13. Headache Clinic
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How Is Pediatric/Adolescent
Headache Diagnosed?
Diagnoses and Treatment
An accurate diagnosis is the first step to effective treatment in children and adolescents with
headache. A pediatric headache specialist should evaluate your child thoroughly, including a
physical exam, inquiries into medical and family history, and diagnostic tests. The child may be asked
to describe the pain, its location, the duration of the headache and more. The specialist may ask
parents about changes in behavior, personality, sleeping patterns, emotional stress and if physical
trauma preceded the headache. If symptoms indicate migraine or tension headache, specialists may
not recommend further testing. But sometimes, additional diagnostic tests may be necessary; these
may include blood tests, an MRI or CT scan, or a polysomnogram to check for a sleep disorder.

14. Headache Clinic
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What Is the Recommended Pediatric/
Adolescent Headache Treatment?
Diagnoses and Treatment
Each child receives an individualized treatment regimen that may include these components:
Medication. Specific therapeutic agents are prescribed, and patient response is closely monitored
to evaluate efficacy and minimize side effects.
Lifestyle Modification. Patients are instructed in the areas of diet, recreation, sleep patterns and
other habits linked to headaches.

15. Headache Clinic
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Diamond Diagnoses and Treatment
Biofeedback Training. This is a non-drug therapy that enables patients to actively participate in their
treatment while alleviating headache symptoms. About 70% of all patients, and especially children,
benefit from this training. Biofeedback augments other therapies and is particularly useful for
patients for whom stress is a major contributing factor to headaches, or for those patients who are
unable to use standard headache agents.
What Is the Recommended Pediatric/
Adolescent Headache Treatment? (continued)