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Ibuprofen is effective for boys but not for girls
Many children have migraine - from about 5% among those of primary school age up to about 20 % of those in late teen-age.137 children between 6 and 12 were given 7.5 mg/kg of liquid Ibuprofen or an equivalent solution containing a placebo. They reported their condition 30, 60, 90, 120, 180 and 240 minutes after ingesting the liquid.
To everyone´s surprise, a greater proportion of the boys who had taken Ibuprofen felt better after 30 minutes than those who had taken the placebo, and this difference continued to the termination of the study at 240 minutes. There was no difference between the reaction of the girls who had taken the placebo and those who had taken Ibuprofen. The reaction of the girls to both Ibuprofen and to the placebo was similar to that of the boys who had taken Ibuprofen.
The scientists cannot explain this difference between boys and girls and would like to see more studies of a similar type with a larger number of participants.
D. W. Lewis, D. Kellstein, G. Dahl, B. Burke, L. M. Frank, S. Toor, R. S. Northam, L. W. White and L. Lawson, 2002. Children´s ibuprofen suspension for the acute treatment of pediatric migraine. Headache 42, 780-786.
Uploaded 14-12-2004
Asthma medicine for children with migraine
There are slightly more asthma patients among migraineurs than expected. But now there is good news for these people. A study of the effect of asthma medicine on 6 children between the ages of 9 and 13 who had both asthma and migraine has shown that the treatment reduced substantially the number of migraine attacks suffered by the children. The children reported how many migraine attacks they had for 8 weeks before treatment began and for 3 periods of 8 weeks after the start of treatment with a leukotriene antagonist.There is still a need for a controlled study of this type of medicine, in that the patients in this study knew that they were receiving an active medicine. We therefore do not know of any placebo effect.
D. de Souza Carvalhom Y. D. Fragoso, F. M. S. Coelho and M. M. Pereira, 2002. Asthma plus migraine in childhood and adolescence: prophylactic benefits with leukotriene receptor agonist. Headache 42, 1044-1047.
Uploaded 14-12-2004
Sleep migraines away
Between 3 and 7% of all children experience migraine and most of those have an attack at least once a month. Migraine begins most often around the age of 10, but there are children who have experienced their first migraine attack at the age of 2. (1)3 out of 4 children have family members (parents) who also have migraine. Children who develop migraine before the age of 10 have on average more family members (especially parents) who have migraine.
On the other hand, only 40% of parents who have migraine pass it on to their children.
Most attacks last only a short time; ca. a half of all children have attacks that last under 2 hours. Only about 10% of children have attacks that last more than 24 hours.
4 out of 5 children use sleep as a technique to get over their attacks. But many also take medicine to reduce the pain. 10% of migraine children say that they often waken because of migraine.
Children who experience their first migraine before the age of six have a greater probability of continuing to have migraine, and that their migraine will be worse, than those who experience their first attack after this age.
Children´s experience of migraine is just as unpleasant as that of adults. In a study of 999 attacks, children coped by falling asleep during 329 of them. 126 attacks disappeared during 1½ hours´ sleep and 203 disappeared during up to two hours´ sleep. The youngest children especially tend to sleep their way out of attacks. Young girls have a greater tendency than boys do to sleep their attacks away, while among older children, boys tend to sleep attacks away more than girls do.
In general, attacks get longer with age and it becomes more difficult for the child to sleep an attack away (2).
(1) M. A. Hernandez-Latorre ad M. Roig, 2000. Natural history of migraine in childhood. Cephalalgia 20, 573-579.
(2) K. Aaltonen, M. L. Hämäläinen og K. Hoppu, 2000. Migraine attacks and sleep in children. Cephalalgia 20, 580-84.
Uploaded 14-12-2004
Nasal spray for children
Eighty-three children between eight and seventeen years old were treated with either an Imigran (Imitrex) nasal spray or a placebo spray against migraine attacks. The dosage was 10 mg if they weighed less than 40 kg and 20 mg if they were heavier. Two hours after use of the Imigran nasal spray 64% of the children felt much better, while only 39% of those that used the placebo felt better.Approximately one in three children complained that the spray did not taste nice, but none mentioned other side effects.
K. Ahonen, M. L. Hämäläinen, H. Rantala and K. Hoppu, 2004. Nasal sumatriptan is effective in treatment of migraine attacks in children. Neurology 62:883-887.
Uploaded 02-03-2005
Preventive treatment of children with migraine
Some children have so much migraine that it can be necessary to consider treating them preventatively. There have been various studies in different parts of the world with various medicines that are also used for adults.Amitriptyline (Saroten) is an anti-depressive that gave 80% of 192 children a significantly reduced the incidence of attacks, but individual attacks lasted just as long as before treatment.
Propranolol (Inderal, Propal) is an anti-depressive beta-blocker and a series of tests on children have given resuæts that vary from total cessation of attacks in 71% of children to increased migraine.
Cyproheptadin (Periactin) is an antihistamine that halved the number of attacks of 83% of a group of children, but also made them apathetic and increased their appetite. Clonidin (Catapresan) is an anti-epileptic drug that one study showed acted positively but another showed no effect.
Topiramat (Epitomax, Topimax) is an anti-epileptic drug that reduced the number of attacks suffered by a group of children by 70%. They reported such side-effects as apathy, lack of appetite and loss of weight.
Gabapentin is also and anti-epileptic drug that similarly halved the number of attacks suffered by 80% of a group of children.
Naproxen sodium (Bonyl, Naprosyn) is an NSAID that was tried on 10 youngsters of whom 6 had less than half as many attacks as before the treatment. So if a child suffers really many migraine attacks, it is perhaps worth discussing with her doctor the if it might be advisable to try preventative treatment. None of the reported studies were on a large number of children, so the results should be used only as a guide.
D. W. Lewis, S. Diamond, D. Scott og V. Jones, 2004. Prophylactic treatment of pediatric migraine. Headache 44, 230-237.
Uploaded 26-05-2005
School days missed by migraine children
An American study has shown that ca. 9% of 222 children had migraine which conformed to the International Headache Societ´s (IHS´s) definition of migraine. 66% of the children had at least one parent who also had migraine. Nearly 80% of the children occasionally had to stay home from school because of migraine, and only 20% of the children had been to a doctor because of their migraine (1).One study demonstrated that 113 Swedish school children (8 - 15 years of age) with migraine experienced more stress and had more psychological symptoms and had more absentee days from school than children without migraine.
(1) Reuters 4. July 1997.
(2) Headache 36, 77-82, 1996.
Uploaded 14-12-2004
Migraineur children cope well with school
Researchers treated 283 youngsters between the ages of 11 and 18 for their headaches and migraine. They also got data from the childrens´ schools about how well they did there. The researchers used information from the children themselves about how they felt about their headaches and migraine to divide them into two groups of badly afflicted and not so badly hit. They found no difference between the two groups in respect of how they coped with school.The children were also divided into groups of those who had been absent on more than two days during the previous half year because of their headache/migraine and those who had been absent for two days or less. The only difference between the two groups was that those who were absent most carried out their written work better. The two groups were equally good at sport, music, drama and all other school activities. Nor was there any differece in any tendency of the children to be depressed.
The children in this study were all badly enough affected by headache or migraine that they had been referred to a clinic for special treatment. It cannot therefore be concluded that migraine doesn´t affect the youngsters´ activities - only that there is no difference between the badly affected and the very badly affected.
C. C. Breuner, M. S. Smith og W M. Womack, 2004. Factors related to school absenteeism in adolescents with recurrent headache. Headache 44, 217 - 222.
Uploaded 26-05-2005
Teenagers with headache or migraine are hard hit
74 Italian teenagers (10 - 18 years old) with migraine and an equivalent 84 control subjects were asked about their view of life. It was found that those with headache/migraine were significantly influenced by their migraine. They reported that they were less well-off psychologically, were more anxious, had a greater tendency to depressive states, spent less time with their brothers and sisters, functioned less well in school, felt they functioned less well and were more tired. The patients were chosen from those who visited a headache clinic, so the study was conducted on those who were particularly hard hit.E. Nodari, P. A. Battistella, C. Naccarella og M. Vidi, 2002. Quality of life in young Italian patients with primary headache. Headache 42 268-274.
Uploaded 14-12-2004
Intelligence of migraine children is the same as for their brothers and sisters
A study of 37 migraineur children with 17 migraine-free brothers and sisters showed that the two groups answered just as well to a series of tests that investigated their ability to understand and other mental abilities.The only difference found was that migraineur children were slightly better than non-migraineurs at answering correctly to a special test containing a series of words.
F. Haverkamp, A. Hönscheid and K. Müller-Sinik, 2002. Cognitive development in children with migraine and their healthy unaffected siblings. Headache 42, 776-779.
Uploaded 14-12-2004
Families with migraineur children can make things easier for the children
Migraine affects a child´s daily life, especially if they suffer attacks themselves. Children say that they have less time to play and to learn. Other migraineurs in the family also affect its children. Children of chronic migraineurs have more days with migraine and have less surplus energy than other children. The children also learn to define the symptoms of migraine earlier if an adult in the family has migraine.Now a group of Italian scientists has looked more closely at the quality of life of migraineur children. Not surprisingly, many and long migraine attacks give a lower quality of life, but the intensity of the migraine also affects the children´s quality of life. Children who themselves say they are good at dealing with their migraine have a better quality of life than those who feel that it is difficult to cope with the attacks. In addition, the scientists wrote that the family´s routines for coping with a child´s attacks were to a great extent a significant factor in the child´s quality of life.
The Danish Migraine Association therefore asked one of the scientists (Dr. Frare) which routines should be especially good and was told that the routines that should be especially good would be different in different cultures, but that the best routines in this connection were those that try to balance the needs of the family so that other family members can still carry on even though the child has migraine.
M. Frare, G. Axia og P. A. Battistella, 2002. Quality of life, coping strategies, and family routines n children with headache. Headache 42, 953-962.
Uploaded 14-12-2004
Children with migraine have a clearly reduced quality of life
While visiting a clinic in Ohio, USA, for treatment for their migraine, 572 children were asked to complete a form to assess the quality of their lives. Their replies demonstrated that their quality of life was reduced as much as if they had had rheumatoid arthritis or cancer. Their school work and the emotional aspects of their lives were particularly affected by migraine. Children with chronic headache were most seriously affected.S. W. Powers, S. R. Patten, K. A. Hommel and A. D. Hersey, 2003. Quality of life in childhood migraines: clinical impact and comparison to other chronic illnesses. Pediatrics 112, 1-5.
Uploaded 02-03-2005
Children and teenagers are hampered by migraine
It is mostly the social life of younger children that suffers because of migraine. The school activities of teenagers suffer more. Parents of teenagers with migraine generally believe that their children are inhibited by their migraine, while parents of younger children are less concerned. These were the results of a questionnaire returned by 686 children and teenagers (2 – 18 years old) who visited a migraine clinic in Cincinnati, USA.S. W. Powers, S. R. Patton, K. A. Hommel and A. D. Hershey, 2004. Quality of life in pediatric migraine: characterization of age-related effects using PedsQL4.0. Cephalalgia 24, 120-127.
Uploaded 02-03-2005
Children of migraineur mothers have adult responsibilities early
Mothers with migraine know it – we ask our children to do some of the many tasks we cannot cope with ourselves. Now it has been documented that children who have a mother with migraine and a father without this problem are asked to do more ‘adult’ tasks than children of other mothers. The study also documented that the migraineur mothers are just as caring and have as much empathy as other mothers and they do not punish their children more than others.M. A. Fagan, 2003. Exploring the relationship between maternal migraine and child functioning. Headache 43, 1042-1048.
Uploaded 02-03-2005
Adult migraineurs have a tendency to be anxious, but children are more relaxed
A study of 47 migraine children between 6 and 17 years old and 33 control children showed that there is no difference between the migraineurs and other children in their tendency to require attention, be hyperactive, behave badly, be anxious or be depressed. The migraineur children had a slightly greater tendency than the control children to answer back.This is noteworthy, because adult migraineurs have a tendency to be more anxious than non-migraineurs.
The scientists think that the tendency of the migraineur children to answer back is because they are more sensitive to criticism than other children and that is because they have higher amounts of growth hormone in their blood than the others.
A. Pakalnis, J. Gibson and A. Colvin, 2005. Comorbidity of psychiatric and behavioral disorders in pediatric migraine. Headache 45, 590-596.
Uploaded 21-10-2006
Childrens´ migraine starts during the day
A study sponsored by GlaxoSmith-Kline has shown that most migraine attacks in children begin during the day. Only rarely do the attacks begin before 6 am. The starting time is fairly evenly spread out during the day with 20% beginning between 6 am and 9 am, 20% beginning between 9 am and 12 noon, 20% beginning between 12 and 3 pm, 20% beginning between 3 pm and 6 pm and finally 20% beginning after 6 pm.Attacks were evenly spread over the week, with slightly fewer on Saturdays.
P. Winner, A. D. Rothner, D. G. Putnam and M. Asgharnejad, 2003. Demographic and migraine characteristics of adolescents with migraine: Glaxo Wellcome clinical trials’ database. Headache 43, 451-457.
Uploaded 02-03-2005
Child migraine and sleep
Children with migraine have more disturbed sleep than other children, but we do not know whether the migraine causes the disturbances or the disturbances that cause the migraine.118 children between 2 and 12 years old and their parents were asked about the childrens’ sleeping habits. More migraine children than expected gritted their teeth and sleep-walked. The parents of migraine children thought that their children did not sleep enough, but the children were not asked specifically about this.
V.A. Miller, T. M. Palermo, S. W. Powers, M. S. Scher and A. D. Hershey, 2003. Migraine headaches and sleep disturbances in children. Headache 43, 362-368.
Uploaded 02-03-2005
Children move less during the night just before a migraine attack
Eighteen children with migraine and a control group kept a migraine diary and were observed while they slept at night. On nights immediately before a migraine attack, the migraine children moved less during their sleep compared both to other nights and to the control children. The migraine children also moved about less during the night just after a migraine attack.The two groups of children slept the same number of hours and woke up equally often, but the migraine children spent a longer time going to sleep after the lights were put out.
O. Bruni, P. M. Russo, C. Violani and V. Guidetti, 2004. Sleep and migraine: an actigraph study. Cephalalgia 24, 134-139.
Uploaded 21-10-2006
Migraine children sleep more
A study of 100 children with migraine or geadache showed that children having a migraine were 6 times more likely to go to sleep than children with a headache.33% of the children with migraines had been sleepwalkers, but the headache patients were no more likely than the general population (2 – 7 %) to have been sleepwalkers.
O. Casez, Y. Dananchet and G. Besson, 2005. Migraine and somnambulism. Neurology 65, 1334 – 1335.
Uploaded 02-03-2005
Children and young people develop chronic migraine/headache more quickly than adults
Forty children and young people (aged 7 - 14) took part in the study. Twenty six of them had chronic migraine (i.e. migraine more often than 15 days per month). On average, they took 11 doses of painkillers per month, but some took more than 20 doses.The doctors think that the youngsters had developed the chronic migraine from attacks of ´normal´ migraine during about 1½ years, substantially more quickly than adults do.
S. B. Esposito og J. L. D. Gherpelli, 2004. Chronic daily headaches in children and adolescents: a study of clinical characteristics. Cephalalgia 24, 476-482.
The Danish Migraine Association thinks that it is important to be aware of youngsters´ migraine and headaches and to try to reduce the number of attacks they get rather than trying to treat their attacks with painkillers, which can quickly develop to drug-induced migraine.
Uploaded 26-05-2005
Nose bleeds common among child migraineurs
45 American migraine children between the ages of 6 and 11 and a comparable control group of 64 were asked if they had nose bleeds occasionally. 36% of the migraineur children but only 11% of the control group had regular nosebleeds.Nose bleeds began 3 years before the children began to have migraine. The nose bleeds often started at night while the children slept.
I. T. Jarjour and L. K. Jarjour, 2005. Migraine and Recurrent Epistaxis in Children. Pediatric Neurology 33, 94-97.
Uploaded 21-10-2006
Headache or migraine every week is a strain for young people
Young Canadian people (12 – 15 years old) with migraine at least once a week have a poorer life than their healthier comrades. They are not especially happy to go to school, they feel they cope badly, that their teachers treat them unreasonably, that their parents make unreasonable demands and they don´t complete all their homework.They often forget to eat breakfast and they smoke and drink more than their healthy friends. They aren´t happy, are very worried and feel that their parents don´t care for them.
All of these symptoms are in comparison with their healthy friends, so they are not due to the ordinary teenage rebellion but show that teenagers with migraine feel things worse than average.
26% of 12-year-olds had headache or migraine at least once a week compared to 31% of the 15-year-olds. 1694 12-year-olds and 1764 15-year-olds were asked their opinions.
J. M. Dooley, K. E. Gordon og E. P. Wood, 2005. Self-reported headache frequency in Canadian adolescents: Validation and follow-up. Headache 45, 127-131.
Uploaded 21-10-2006
Increase in S100-beta in the blood of migraineur children
S100-beta is a protein that is found in increased amounts in the blood of patients with brain damage, early-stage AlzheimerLs and other conditions that resemble inflammation of the central nervous system (the brain and spinal chord). Among other things, the chemical causes nerve cells to branch and grow more quickly. So a group of scientists speculated whether or not migraineurs should have more of this chemical than other people.They compared 15 children with migraine, 10 with tension headache and 23 healthy children, and discovered that the migraineur children had a significantly higher amount of S100ƒÀ than the healthy ones.
O. Papandreou, A. Soldatou, A. Tsitsika, C. Kariyannis, T. Papandreou, A. Zachariadi, I. Papassotiriou and G. P. Chrousos, 2005. Serum100-beta-protein in children with acute recurrent headache: a potentially useful marker for migraine. Headache 45, 1313-1316.
Uploaded 21-10-2006
Ice cream headache is common among young people
8,359 young people between 13 and 15 years old in Taiwan were asked whether they got pain in the head when they ate something cold. Almost 41% of the youngsters knew this type of headache. Slightly more girls than boys reported ice cream headache and those who had migraine were also more likely to have ice-cream headache.Only 5% of the youngsters got ice cream headache every time or almost every time they ate something cold and, for the majority, the pain disappeared within a minute. Only 1% of the youngsters gave up ice cream because of the pain.
J.-L. Fuh, S.-J. Wang, S.-R. Lu and K.-D. Juang, 2003. Ice-creme headache – a large survey of 8359 adolescents. Cephalalgia 23, 977-981.
Uploaded 14-12-2004
Cola drinks and migraine - maybe/maybe not a connection?
19 boys and 17 girls with chronic migraine were referred to a migraine clinic in Israel. The doctor had a suspicion that they drank large amounts of cola drinks (of various types) and that their migraine was caused by the caffeine in the colas. He therefore asked the young people to stop drinking cola.It was shown that the youngsters drank an average of 1.5 litres of cola every day and that this amount contains nearly 200 mg caffeine; equivalent to two cups of coffee. When the young people stopped drinking cola, migraine attacks disappeared in 33 of the 36 during 2 weeks. The remaining three had an occasional attack, but not so many that there was a reason for prescribing prophylactic medicine.
The authors think that it was the caffeine content of the cola drinks that had given the youngsters migraine. The paper mentions the caffeine content of cola light (of various brands) and cola containing sugar, but does not specify whether the authors had asked the youngsters which type they drank.
R. Hering-Hanit og N. Gadoth, 2003. Caffeine-induced headache in children and adolescents. Cephalalgia 23, 332-335.
The Danish Migraine Association speculates whether the youngster´ migraines may have been induced by the aspartame content of ´light´ cola and has therefore e-mailed Dr. Hering-Hanit and asked whether the young people were asked specifically which type of cola they drank. We received the following answer: ´The excessive caffeine consumption was of ´regular´ cola drinks. Aspartame can indeed trigger headache and migraine. Nevertheless, it does not seem to be the trigger in this group.´ We did not get an answer about whether the youngsters were in fact asked if they drank ´light´ or ´regular´ cola and how much they drank of each type.
Uploaded 14-12-2004