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Pediatric Migraine Treatment: Finding Relief With Safe Alternatives

Pediatric Migraine

Photo by Caleb Woods on Unsplash

Kids are only a small part of the conversation when it comes to migraine, but 1 out of every 10 children between ages 5 and 15 lives with some form of migraine. In fact, of all cases in which children and their parents seek neurological care due to persistent headache, 75% of those cases are linked to migraine.

Couple this with the lack of FDA-approved migraine treatments for kids, and it’s easy to see how the path forward becomes difficult to navigate — especially for parents who may not feel comfortable filling a prescription that is yet to be proven safe in clinical trials (this is called off-label prescribing, which we will discuss later in the article). This leaves families in a tricky position. After all, in these young years that are supposed to be healthy and carefree, the last thing your child or teen should have to worry about is a debilitating migraine.

Luckily, new research is guiding the way to child migraine management alternatives that you and your kid can feel good about. In this article, we’ll take a closer look at migraine in kids and some of the treatments that can provide safe and effective relief without a prescription.

How common is pediatric migraine?

Here’s how child and adolescent migraine break down by the numbers:

  • 2.5% of kids under the age of 7 experience migraine attacks.
  • 5% of children experience migraine between age 7 and puberty.
  • ~25% of kids with pediatric migraine will be migraine-free by the time they reach 25.
  • More than 50% of kids with migraine will still experience attacks when they reach 50.
  • Half of all migraineurs have their first attack before the age of 12.
  • Up to 28% of teens aged 15-19 are affected by migraine.
  • While boys have more migraines than girls before puberty, 23% of girls will have had a migraine by age 17, compared to only 8% of boys.

    What are symptoms of migraine in a child?

    For an adult, it’s usually easy to describe symptoms — but for young children, it can be extremely difficult to describe these strange, complex, and even multi-faceted feelings of discomfort. (Just imagine the list below through the lens of a child!) Doctors argue that this presents an added difficulty in the diagnosis of migraine in kids, while some deem it reason enough to view symptomatology more liberally when making a diagnosis.

    With this taken into account, it’s interesting to note that the International Headache Society’s diagnostic criteria for pediatric migraine are broader than the criteria for adults. Though, in general, child migraine symptoms are nearly identical:

    • Headache lasting 4 to 72 hours
    • Pulsating pain on one or both sides of the head
    • Nausea
    • Vomiting
    • Photophobia (sensitivity to light)
    • Phonophobia (sensitivity to sound)
    • Migraine aura

    One pediatric migraine symptom missing from this criteria is acute anxiety, which is known to occur in the midst of an adult migraine attack. Interestingly, the mind and body relaxation skills taught in cognitive behavioral therapy to help manage anxiety have been shown to be effective in migraine management for kids. (We’ll dive deeper into this later on in the article when we talk about safe treatments.)

    What causes migraines in children?

    About 30% of the almost 40 million people who suffer from migraine in the U.S. experience disturbances in vision, sensation, or speech. These disturbances are commonly known as aura, which is why this type of migraine is known as migraine with aura. Migraine with aura is less prevalent amongst children, as over 90% experience migraine without aura.

    Thanks to a gene sequencing study of 23,000 individuals with migraine, we now know that family history has strong implications for migraine without aura. This is why ~70% of children and adolescents with migraine also have at least one immediate family member with the same condition.

    Which pediatric migraine treatment is safe?

    Consulting a pediatrician or headache specialist is an important first step when considering how to treat migraine in a child. Not a single pediatric migraine medication is approved by the FDA for children under 12. In certain cases, however, doctors may recommend pharmacological treatment. This practice, referred to as prescribing “off-label,” may offer short-term relief. However, it doesn’t take into account the unknown, long-term implications of these drugs.

    Questions have also surfaced regarding preventive medications for children. 50% of children and adolescents report improvement within 6 months after treatment, but a recent analysis suggests that the positive effects of pill-taking therapies are predominantly the result of placebo. In some cases, placebos may even have a stronger positive effect than prescription drugs.

    A 2019 study reiterates these findings, suggesting that lifestyle changes, healthy habits, and behavioral counseling should make up the first line of treatment in cases of migraine headache in a child. Groundbreaking new research also suggests that narrow-band green light is a safe, non-invasive, and effective treatment for managing migraine and soothing attacks when they happen.

    Start by pinpointing migraine triggers.

    Just as in adults, understanding and managing migraine triggers is one of the most effective ways to keep a child’s attacks at bay. The easiest way to do this is to keep an ongoing migraine diary where you and/or your child can document symptoms, intensity, and possible triggers - such as diet, sleep, and stress - all of which may play a role in the frequency and severity of attacks. Some of the most common triggers to keep tabs on are:

    • Stress - A 2014 study shows that a significant drop in stress levels from one day to the next may put migraineurs at a higher risk of an attack on the subsequent day.
    • Lack of sleep - The Migraine Research Foundation reports that quality sleep — the lack of which is one of the most common triggers of a migraine attack — is an effective treatment on its own for some children.
    • Hormones - Girls make up a large majority of adolescents with migraine post-puberty, whereas boys account for the majority of pre-puberty migraine cases. (Although this is something that can’t be controlled, it’s still important to recognize that migraine can appear when menstruation begins.)
    • Strong smells and perfumes - A 2016 survey of nearly 4,000 U.S. migraineurs revealed that strong or pungent odors such as perfumes are one of the five most prevalent migraine triggers.
    • Diet - Certain foods such as aged cheeses and cured meats are well-documented migraine triggers.

    Consider cognitive behavioral therapy.

    Scientists have proposed a connection between mood and migraine in children. Although the physiological mechanisms of such a connection remain unknown, therapies aimed at mood- and stress-management show promising effectiveness as migraine treatments for kids. Of these therapies, cognitive behavioral therapy is probably the most well-known and widely available.

    In one small, qualitative study, an overwhelming majority of pediatric migraine patients and their parents reported that CBT was effective in reducing headache frequency and related disability. A separate study, published in 2020, found a significant decrease in monthly headache frequency after just 8 weeks of CBT. It went on to suggest that this may in part be due to positive changes in brain function, especially in the amygdala (the part of the brain that regulates emotions), observed by researchers.

    These promising results might make you wonder why CBT isn’t more widely used for migraine treatment. In large part, this is because of financial and cultural barriers: not only can CBT be costly, but stigmas and skepticism surrounding therapy and mind-body connections can prevent parents and patients from considering this option.

    Turn to narrow-band green light.

    In 2016, Dr. Rami Burstein of Harvard University published the results of a study in which he made a rather curious finding: of all colors of light, only a specific, narrow band of green light soothes photophobia (light sensitivity) and other symptoms caused by a migraine attack. Four years later, a separate team of researchers used these foundational findings to execute a new study, the results of which suggest that regular exposure to narrow-band green light actually reduces the frequency and intensity of migraine headaches. A mere one to two hours of daily exposure to narrow-band green light yielded an astonishing 50+% reduction in the number of headache days per month for a majority of both chronic and episodic migraineurs.

    The same frequency of green light proven effective in these studies is now widely available, thanks to the Allay Lamp. For about the cost of a single, full-price session of CBT, and with no off-label drug risks, you can purchase a portable, chargeable, and dimmable lamp that your child can turn to when a migraine strikes. Incorporate this light into their daily routine for one to two hours at the end of every night to reap some of the preventative benefits experienced by participants of the study mentioned above.

    Most importantly for families and migraineurs of every age, this patented narrow-band green light is 100% safe with zero negative side effects. Plus, even when not in use for headache, it’s bright enough to provide ample light for reading and other activities that kids and their families enjoy.

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