Migraines Are Frequently Misdiagnosed or Undiagnosed
Migraine headaches affect about 18% of women and 9% of men at some point in their lives. However, this common illness is often misdiagnosed as “tension headache”, “sinus headache”, or allergy. Children and teens are not only misdiagnosed, but are susceptible to going undiagnosed. Very often, it is during these formative years that migraine develops – it afflicts an estimated 10% of young children and up to 28% of teens. Children may especially complain about headache during the school year, which may in fact be migraine, due to the lack of sleep and/or added stress.
Here are some of the characteristics of migraines in both adults and children that help differentiate them from other headache syndromes:
Unilateral headache A headache that is primarily on one side only, or “unilateral”, is very typical of migraine, but not typical of other headache types. In children, however, headache may manifest across the forehead or in the temples. Some children don’t experience head pain, but instead experience abdominal or stomach pain, called an abdominal migraine.
Throbbing Headaches that throb, or pulse with the heartbeat are more often migraine
Photophobia Light sensitivity is very common in migraine, but very uncommon in other headaches. Sufferers often report that light, especially outdoor light and non-incandescent light, is very bothersome during an attack. Many sufferers report that light sensitivity can even trigger an attack
Phonophobia Sound sensitivity is also common during a migraine. Even the sound of the TV or music can be irritating during an attack
Nausea and Vomiting Nausea, even if mild, is more likely to be associated with a migraine than with other headache types
Car Sickness Adults with migraine often have a history of being carsick or motion sick as children.
Aura About a third of the migraine sufferers in the U.S. experience migraine with aura. Aura refers to the visual warning signs of a migraine.
Note that headache severity is not one of the criteria! Although migraines can be severe, they vary across a wide spectrum – some people have migraines that are mild enough that they might not even need an aspirin for it. Others have headaches severe enough to land them in the emergency room. Most migraines fall somewhere in-between.
If you think you, or your children, have migraines, you should discuss it with your primary care physician or neurologist. Children especially may need to see a pediatric neurologist. Your doctor can help make the correct diagnosis and guide you toward appropriate medical and non-medical therapy.
Sources for further information:
Migraine Research Foundation
Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgia and facial pain. Cephalgia 1988; 8(Suppl. 7): 1-9
Headache in Clinical Practice. S D Silberstein, R B Lipton, P J Goadsby (eds). Mosby-Year Book Inc., St Louis, MO. 1998
Cuomo-Granston A, Drummond PD. Migraine and motion sickness: Prog Neurobiol 2010. 91:300-12
Wessman. Cortical spreading depression-Migraine: a complex genetic disorder; Lancet Neurology, 2007