The unbelievable headache
Migraines in kids can be life-changing and hard to diagnose
Friday, October 19, 2007
Imagine a headache that feels like "having nails shoved into your temples." Imagine a headache that often includes vomiting. Imagine a headache that forces you to quarantine yourself off from the world for some relief.
Now imagine having that headache every day.
It wasn’t always this way for 15-year-old Brittany Johnston. She started suffering from migraines when she was 8 but she was quickly diagnosed and put on medication, which controlled the attacks. But since contracting viral meningitis at 11, she lives with a constant migraine every day.
"She became non-functioning. She was totally incapacitated by these migraines," says her mother Amy. "She was so sick. She was alone basically."
Brittany missed most of her sixth and seventh grade years, which she spent sleeping in a dark room most of the day. Her mother took her everywhere in their area for treatment and was eventually referred to the Diamond Headache Clinic in Chicago. The staff at the clinic began trying as many remedies as they could on the young girl, including Botox injections and different diets and medications. Finally Dr. Seymour Diamond found a combination that greatly reduced, but didn’t eliminate, Brittany’s headaches.
Her mother is relieved.
"She had missed so much of her life. At least a whole year of her life she didn’t get to do anything. She’s quite a trooper. She’s driving now. She’s doing normal high school stuff."
While migraines are common in adults, there’s not much talk about them in children because they are difficult to diagnose in young ones, Diamond says.
"They are quite common but they are often unrecognized because often they are laid down to stress or they think the child is trying to get out of their normal activities they may dislike. It’s very common for people to ignore or have a misconception of it," he says.
He says migraines can occur as early as age 1, though most start about 5 or 6. They are more prevalent in boys until girls start their menstrual cycle.
Though for some girls, like Kaylee Guzman, 10, the pain begins earlier. Guzman was diagnosed in 2004 with migraines and has been on several drugs since to stop the pain.
"The pain is still there," says her mother, Eroilda Quiles, of Evergreen Park. "It’s a little better with the medication."
In younger children, the migraine isn’t always in headache form, but can show up as stomach aches or dizziness. These symptoms are often recognized as predecessors to migraine headaches.
Dr. Kenneth Silver, a pediatric neurologist at the University of Chicago’s Comer Children’s Hospital, defines a migraine as a "throbbing headache in the front part of the head lasting at least an hour, which is at least moderate to severe."
Most doctors believe these headaches are genetic, though there is some debate about how often the trait is passed on. In some instances, as in Kaylee’s case, parents are migraine-free and the condition comes from a grandparent.
Diagnosing migraines is not easy, Diamond says.
"If a child has persistent headaches—and I’m not talking about daily headaches, but headaches that occur episodically and with other symptoms like gastrointestinal upset or dizziness or abdominal pain that is unexplainable—it could be due to migraines," he says.
"I think any child with repeated headaches or with daily headaches should be neurologically examined and probably have an MRI."
Once the condition has been identified, patients and their parents are often asked to keep a journal of what foods were eaten, what the weather was like, how much sleep they had or general life events. This allows doctors to identify triggers that cause the headaches. Often, Silver says, it’s simple stress.
"Often, when they start keeping a diary, we can identify triggers and eliminate them," he says. Because it’s difficult to eliminate stress completely, patients are taught how to deal with it, often significantly reducing the frequency and the severity of the headaches.
Other common triggers include certain foods, skipping meals, the weather and lack of sleep.
"The migraines get worse when Kaylee’s in school. When she’s reading a lot or watching too much TV there’s a lot of headaches," Quiles says. "Sometimes she’s sleeping and she wakes up with the headaches."
Medications for infrequent sufferers are often over-the-counter pain pills that don’t work for adults but have surprising affects for children. For those who suffer more frequently, a preventative medication is often given, Silver says.
The ordeal can be frustrating for both parent and child. Some parents, if they’ve never had a migraine, can’t understand why a headache can be so damaging. That was the case with Johnston. She never had a migraine and suddenly both her daughter, Brittany, and her son, Luke, suffer from them.
"They are in so much pain all the time so then they start to become depressed," she says. "As a parent I would have never thought that a migraine headache could take over our lives like they did."
But, she says, it’s important to remember there’s hope.
"We’re in a great place now," she says. "We’d be in a better place if my daughter woke up without a headache."
Christy Breithaupt, a freelance writer living in Chicago, became a new mom last month.