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Migraine is one of the commonest problems I see in my paediatric neurology practice. Migraine can be very debilitating, and appropriate management is important.

Typically I will ask how long the headaches have been going on, what they feel like (throbbing, stabbing etc), where they hurt most, how often they occur, what makes them better, what makes them worse. I also ask about associated features like visual disturbance, nausea or vomiting. Family history often identifies migraine in a close relative.

A headache diary is very useful. It helps to identify the frequency and duration of migraines, as well as possible triggers.

By the time a child comes to me for review the headaches have caused significant concern and worry, so I usually request an MRI scan of the brain.

Red flags for headaches in children include:

  • Early morning onset with vomiting
  • Onset under age 6
  • Constant, worsening headache
  • Associated symptoms like confusion or weakness
  • A change in the appearance of the child
  • Loss of balance or co-ordination
  • An abnormal neurological examination

www.migraine.ie is a great resource for people with migraine.

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