Picture this. Your 9-year old daughter staggers to the breakfast table; hands on head, and moans plaintively, "I can't go to school today. I have a headache."

"Nonsense," you say. You give her an aspirin with breakfast and say, "Off you go. You'll feel better when your history test is over."

But what if this happens every few weeks? Might it be migraine? Is there such a thing as migraine in children?

Betsy's Migraines - a true story

My introduction to the possibility of migraine in children came when I was teaching fourth grade in Massachusetts. That's when I met 9-year old Betsy. Betsy was a pretty child, but headaches kept her from making either friends or academic progress. Betsy claimed to experience regular bouts of migraine in children. Her doting mother vowed that Betsy's attacks were real, but I was skeptical, since they always coincided with things Betsy disliked.

Even more suspicious was Betsy's behavior during attacks. She began with plausible head-holding and tears. She begged for her mother to come and get her. Then, her act always went over the top. Looking around the room to be sure she had attention, Betsy shook her head violently from side to side. "You have to do this when you have migraine," she announced loudly. She hit her head, and turned on the waterworks - always keeping a shrewd eye on her audience. When her mother arrived, Betsy abruptly stopped shaking her head, and moaned piteously. The curtain fell as her mother wrapped Betsy in her arms and ushered her from the room.

True Migraine in Children

While I never received professional confirmation that Betsy suffered migraine in children, I did learn that the condition is authentic. Its name is "migraine in children", even when it refers to only one child.

Facts about Migraine in Children

Migraine affects people of all ages, social classes, races, and cultures. It is most prevalent between ages 20 and 50, but migraine in children hits younger generations. Often misdiagnosed initially as a "headache excuse" to avoid unpleasant tasks, migraine in children is real. Let me give you seven facts.

* Migraine often runs in families.
* Young babies and preschoolers can suffer migraine in children.
* Migraine in children begins earlier in boys than in girls.
* Up to 6 years, boys are affected equally or slightly more than girls.
* At elementary school level, 10 percent suffer migraine in children.
* The prevalence of migraines increases during secondary school.
* 20-30% of young women and 10-20% of young men experience migraines.

Migraine in children attacks every age from birth to age 20.

Symptoms of Migraine in Children

So, since your young daughter may be suffering migraine in children, and not simply avoiding a test, we need to look for signs. What are the symptoms of migraine in children?

1. PAIN: First of all, migraine in children is very painful, with severe throbbing in the head. Your daughter will probably report pain in the forehead, or the middle of the head, rather than just one side.

2. PALLOR: Typically, migraine in children will cause sufferers to appear ill and pale. There may be dark rings around the eyes.

3. QUIETNESS: A child suffering migraine in children will be very quiet. You may have trouble getting your child to say more than, "My head hurts." He or she will choose to sit or lie in aching silence.

4. STILLNESS: Unlike Betsy in the schoolroom, children with migraines do not want to move any part of their bodies. They certainly do not want to shake their heads. If a headache complaint is followed by a running off to play, do not suspect migraine in children.

5. NAUSEA: For those taking notes, we're on the fifth symptom now. Your child may complain of feeling sick in the stomach. He or she may not want to eat anything, and may vomit.

6. ABDOMINAL PAIN: In very young children, the main symptoms of migraine in children are abdominal pain accompanied by nausea and vomiting.

7. VISUAL DISTURBANCES: Some children experience changes in vision during an attack of migraine in children. They may have blurry vision, see flashes of light, or describe zigzag patterns in front of their eyes.

8. PHOTOPHOBIA: Your child may complain of light being too bright, and may want to go to a dark room. For those who like to sound knowledgeable, this light sensitivity is known as photophobia.

9. PHONOPHOBIA: Moving to the eighth symptom, migraine in children may cause them to hold their ears, or complain that you're talking too loudly. Instead of turning up the television volume, they turn it down or off. This is sound sensitivity, also known as phonophobia.

10. OSMOPHOBIA: Migraine in children will sometimes cause sensitivity to smells. Even if you aren't cooking liver-and-onions, your child may complain that dinner smells awful. For those who want the technical term, smell sensitivity is known as osmophobia.

11. MOTION SICKNESS: Those who suffer migraine in children have a tendency toward travel sickness. Even when not in a vehicle, a sufferer may complain of dizziness.

12. CONFUSION: Finally, and this is the last symptom we will look at, if your son or daughter is suffering migraine in children, he or she is likely to exhibit confusion and trouble concentrating. You might tell your teenager, "You aren't thinking straight."

Is It Migraine in Children?

There you have 12 symptoms. Some will exhibit all - others will exhibit a few. Some will have authentic migraine in children - some will not. How do you tell?

PATTERN: First, note whether your child's attacks follow a regular, intermittent pattern. Migraine in children comes back again and again, following a pattern. Look for headaches that are very severe, lasting a few hours, and followed by an interval of no symptoms. Days or weeks later, a similar attack occurs, followed by another symptom-free interval. Migraine in children has a rhythm.

FAMILY HISTORY: Check to see if there is a history of migraine in your family. There may be a tendency toward migraine in children.

PHYSICIAN: Ask your doctor. A doctor will focus on ruling out other serious diseases or underlying conditions. If there are none, you will have the doctor's reassurance, and a plan for effective treatment. I am not a professional, and my information must always be checked with your health care professional.

If your child's attacks are migraine in children, you can provide relief.

Relief of Migraine in Children

* SLEEP: Sleep is the most important factor when it comes to migraine in children. In many cases, several hours of sleep in a dark, quiet room is all that is required.
* ICE PACK: Try placing a cold compress on your child's head as he or she lies in a dark, quiet room.
* OTC: With your physician's approval, use over-the-counter medications such as aspirin, ibuprofen, or acetaminophen.
* PRECRIPTION: Your physician may want to prescribe a medication for recurring attacks of migraine in children.
* WARM BATH: A hot Epsom salt bath may help an older child or teenager.

The most effective of these is usually sleep.

How Migraine Affects Your Children

In closing, I'd like to tell you about Thomas.

Thomas was a mischievous, high-maintenance little boy. From the time he could toddle, Thomas was on the go. Morning to night, he seemed never to stop. He talked incessantly, played loudly. Everything Thomas did was at top speed and volume.

Then, one bright autumn day in his eighth year, Thomas didn't want to eat breakfast. Pale and listless, he lay on the couch, eyes closed. When his buddy called that the school bus was coming, Thomas covered his ears and moaned. When Mother opened the curtains to let in sunshine, Thomas covered his eyes. It was his first migraine.

Thomas lost that day. He missed the introduction of multiplication at school. He missed a film in history class. He missed an afternoon hayride with his cub scout pack.

Thomas lost many days after that. He lost days to migraine in children, and he lost symptom-free days out of fear. He began moving more quietly, more slowly. As additional migraines came and went, his bubbly laughter was gradually replaced by sadness and worry.

Thomas' story is fictional, but it describes the experience of many who suffer migraine in children.

If you think your son or daughter may have migraine in children, I urge you to take him or her to your family doctor. Check for underlying problems, and discuss treatment possibilities.

Whatever you do, don't ignore migraine in children. Appropriate diagnosis and treatment can greatly improve their quality of life.