Headaches and Migraines Information

Headaches and Migraines

Headaches (Adults)

Are there different types of headache? — Yes. There are different types of headache. The 2 most common types are:

• Tension headaches – Tension headaches cause pressure or tightness on both sides of the head.
• Migraine headaches – Migraine headaches often start off mild and then get worse. They often affect just 1 side of the head. They can cause nausea or vomiting, or make you sensitive to light and sound.

Is there anything I can do to feel better when I have a headache? — Yes. Some people feel better if they:

• Take non-prescription pain medicines (but check with your doctor first if you have a health condition or already take prescription medicines)
• Lie down in a cool, dark, quiet room (this works best for migraine headaches)

Should I see a doctor or nurse? — See a doctor or nurse right away if:

• Your headache comes on suddenly, quickly becomes severe, or could be described as "the worst headache of your life"
• You have a fever or stiff neck with your headache
• You also have a seizure, personality changes or confusion, or you pass out
• Your headache began right after you exercised or had a minor injury
• You have new headaches, especially if you are pregnant or older than 40
• You have weakness, numbness, or trouble seeing (migraine headaches can sometimes cause these symptoms, but you should be seen right away the first time these symptoms happen)

You should also see a doctor or nurse if you get headaches often or if your headaches are severe.

Is there anything I can do to keep from getting headaches? — Yes. Some people find that their headaches are triggered by certain foods or things they do. To keep from getting headaches in the future, you can keep a "headache calendar." In the calendar, write down every time you have a headache and what you ate and did before it started. That way you can find out if there is anything you should avoid eating or doing. You can also write down what medicine you took for the headache and whether or not it helped.

Some common headache triggers include:

• Stress
• Skipping meals or eating too little
• Having too little or too much caffeine
• Sleeping too much or too little
• Drinking alcohol
• Certain drinks or foods, such as red wine, aged cheese, and hot dogs

If your headaches are frequent, severe, or long-lasting, your doctor can suggest ways to try to prevent them. For example, it might help to learn relaxation techniques and ways to manage stress. In some cases, medicines can also help.

How is headache treated? — There are lots of medicines that can ease the pain of headaches. You can try taking acetaminophen(sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve). There are prescription medicines that can help, too. The right medicine for you will depend on what type of headaches you get, how often you get them, and how bad they are.

If you get headaches often, work with your doctor to find a treatment that helps. Do not try to manage frequent headaches on your own with non-prescription pain medicines. Taking non-prescription pain medicines too often can actually cause more headaches later.

Headaches (Children)

What types of headaches do children get? — Headaches are common in children. Two of the most common types of headaches in children are:

• Tension-type headaches – Tension-type headaches cause pressure or tightness on both the left and right sides of the head. Tension headaches are usually not severe enough to keep children from doing their daily activities, such as going to school.
• Migraine headaches – Migraine headaches often start off mild and then get worse. They might affect just one side of the head or both. They can cause your child to feel sick or vomit or make your child sensitive to light and sound. They can also cause temporary problems with vision. For example, before getting a migraine, some children see spots or colored lights. When they have a migraine, children are often not able to do their normal daily activities, such as go to school.

Children also tend to get headaches that go along with a cold, the flu, a sore throat, or a sinus infection

In rare cases headaches in children are caused by a serious infection (such as meningitis), severe high blood pressure, or brain tumors.

Should my child see a doctor or a nurse? — You should take your child to the doctor right away (without giving any medicine) if he or she has a headache that:

• Starts after a head injury
• Wakes him or her up
• Is sudden and severe and happens with other symptoms, such as:
  • Vomiting
  • Neck pain or stiffness
  • Double vision or changes in vision
  • Confusion
  • Loss of balance
  • Fever of 100.4°F (38°C) or higher

You should also take your child to see a doctor or nurse if he or she:

• Gets headaches more than once a month
• Has a headache and is younger than 3 years old
• Has a headache and has certain medical conditions, such as sickle cell disease, bleeding problems, immune system problems, genetic problems, heart problems, or cancer

Is there anything I can do on my own to help my child feel better? — Yes. If your child's headache does not fit the descriptions above, you can:

• Have your child rest in a quiet dark room with a cool cloth on his or her forehead
• Encourage your child to sleep, if he or she wants to. Sleep can help, especially with migraine headaches.
• Give your child pain medicine, such as children's acetaminophen (sample brand name: Tylenol) or children's ibuprofen (sample brand names: Advil, Motrin). Never give your child aspirin. In children, aspirin can cause a life-threatening condition called Reye syndrome.

Are there tests my child should have? — Probably not. Most headaches in children are not caused by a serious problem.

Your child's doctor or nurse will probably be able to tell what is wrong with your child by doing an exam and by learning about his or her symptoms. But if your child's doctor or nurse suspects a serious infection or problem, he or she might order an imaging test such as an MRI or a CT scan. Imaging tests create images of the inside of the body.

How are headaches in children treated? — There are many types of medicines used to treat and to prevent headaches. Your child's doctor or nurse will talk with you about which medicine, if any, would work best for your child.

Is there anything I can do to keep my child from getting headaches? — Yes. Some headaches can be triggered by certain foods or things that children do. Keep a "headache diary" for your child. In the diary, write down every time your child has a headache and what he or she ate and did before it started. That way, you can find out if there is anything he or she should avoid.

Some common headache triggers are:

• Skipping meals
• Not drinking enough fluids
• Having too little or too much caffeine
• Sleeping too much or too little
• Stress
• Certain foods, such as bologna or hot dogs

Migraines (Adults)

What are migraine headaches? — Migraine headaches or "migraines" are a kind of headache that can happen in adults and children. They are more common in women than in men. Migraines often start off mild and then get worse.

What are the symptoms of migraines in adults? — Symptoms can include:

• Headache – The headache gets worse over several hours and is usually throbbing. It often affects 1 side of the head.
• Nausea and sometimes vomiting
• Feeling sensitive to light and noise – Lying down in a quiet, dark room often helps.
• Aura – Some people have something called a migraine "aura." An aura is a symptom or feeling that happens before or during the migraine headache. Each person's aura is different, but in most cases the aura affects the vision. You might see flashing lights, bright spots, or zig-zag lines, or lose part of your vision. Or you might have numbness and tingling of the lips, lower face, and fingers of 1 hand. Some people hear sounds or have ringing in their ears as part of their aura. The aura usually lasts a few minutes to an hour and then goes away, but most often lasts 15 to 30 minutes.

Women who get migraines with aura usually cannot take birth control pills. That's because they might increase the risk of stroke.

Many people get other symptoms that happen several hours or even a day before the migraine headache. Doctors call these "premonitory" or "prodromal" symptoms. They might include yawning, feeling depressed, irritability, food cravings, constipation, or a stiff neck.

Is there a test for migraines? — No. There is no test. But your doctor should be able to tell if you have migraines by doing an exam and learning about your symptoms.

Should I see a doctor or nurse? — Yes. If you think you are having migraines, you should talk to your doctor or nurse. You should also see a doctor or nurse if your migraines get worse or more frequent, or if you have new symptoms.

Is there anything I can do to prevent migraines? — Yes. Some people find that their migraines are triggered by certain things. If you can avoid some of these things, you can lower your chances of getting migraines.

You can also keep a "headache calendar." In the calendar, write down every time you have a migraine and what you ate and did before it started. That way you can find out if there is anything you should avoid eating or doing. You can also write down what medicine you took and whether or not it helped.

Common migraine triggers include:

• Stress
• Hormonal changes
• Skipping meals or not eating enough
• Changes in the weather
• Sleeping too much or too little
• Bright or flashing lights
• Drinking alcohol
• Certain drinks or foods, such as red wine, aged cheese, and hot dogs

If your migraines are frequent or severe, your doctor can suggest others ways to help prevent them. For example, it might help to learn relaxation techniques and ways to manage stress. There are also medicines that can help.

Some women get migraines just before or during their period. Medicine can help with this, too.

How are migraines treated? — There are many different medicines that can help with migraines. Your doctor can help you find the best treatment for your situation.

For mild migraines, your doctor might suggest an over-the-counter medicine such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve). There is also a medicine that combines acetaminophen, aspirin, and caffeine (sample brand name: Excedrin). For more severe migraines, there are prescription medicines that can help. If you have severe nausea or vomiting with your migraines, there are medicines that can help with that, too.

Do not try to treat frequent migraines on your own with non-prescription pain medicines. Taking non-prescription pain medicines too often can actually cause more headaches later.

What if I want to get pregnant? — If you want to get pregnant, talk to your doctor or nurse about it before you start trying. Some medicines used to treat and prevent migraines are not safe during pregnancy, so you might need to switch medicines before you get pregnant.

Some women notice that their migraines actually get better during pregnancy and breastfeeding. This is related to hormonal changes in the body.

Migraines (Children)

What are migraine headaches? — Migraine headaches or "migraines" are a kind of headache that can happen in adults and children. Migraines often start off mild and then get worse.

What are the symptoms of migraines in children? — The symptoms of migraines are different based on the child's age:

• In toddlers, symptoms include suddenly getting very pale, being less active than normal, and vomiting.
• In young children, migraines can cause nausea, vomiting, and belly pain, and make children sensitive to light and noise. The headache is often throbbing. It can affect the whole head or just parts of the head. For example, it might affect just the forehead or just the sides of the head.
• In older teens, the symptoms tend to be more like the symptoms adults get. The headache usually starts off slowly and affects only one side of the head. But in younger teens, both sides of the head are often affected.

No matter what age, most children feel better if they lie down in a quiet, dark room while they are having a migraine.

Some children have something called a migraine "aura." An aura is a symptom or feeling that happens before or during the migraine headache. Each child's aura is different, but in most cases the aura affects a child's vision. As part of an aura a child might see flashing lights, bright spots, zig-zag lines, or lose part of his or her vision. Another child might have an aura with numbness and tingling of the lips, lower face, and fingers of one hand. The aura usually lasts a few minutes to an hour and then goes away.

Many children get symptoms that happen several hours or even a day before the migraine headache. Doctors call these "premonitory" or "prodromal" symptoms. The most common are fatigue, irritability, paleness of the face, and shadows under the eyes.

Some teenage girls get migraines every month, around the time their menstrual periods begin. These are called "menstrual migraines."

Should my child see a doctor or nurse? — Take your child to the doctor right away (without giving any medicine) if he or she has a headache that:

• Starts after a head injury
• Wakes him or her up from sleeping
• Is sudden and severe and happens with other symptoms, such as:
  • Vomiting
  • Neck pain or stiffness
  • Double vision or changes in vision
  • Confusion
  • Loss of balance
  • Fever of 100.4°F (38°C) or higher

You should also take your child to see a doctor or nurse if he or she has a headache and:

• Gets headaches more than once a month
• Is younger than 3 years old

Are there tests my child should have? — Probably not. Your child's doctor or nurse will probably be able to tell what is causing your child's headaches by doing an exam and by learning about his or her symptoms. But if your child's doctor or nurse thinks your child might have a serious problem, he or she might order an imaging test such as an MRI or a CT scan. Imaging tests create pictures of the inside of the body.

What can I do to help when my child has a migraine? — When your child's migraine starts:

• Have your child rest in a quiet dark room with a cool cloth on his or her forehead.
• Encourage him or her to sleep.
• Give your child only the medicine or medicines that you have talked to your doctor about.

How are migraines treated in children? — There are lots of prescription and non-prescription medicines that can ease the pain of migraines. There are also prescription medicines that can help prevent migraines from happening in the first place. The right medicine for your child will depend on how often he or she gets migraines and how severe they are. If your child gets migraines often, work with his or her doctor to find a treatment that helps.

If your child has headaches often, do not try to manage them on your own with non-prescription pain medicines. Giving non-prescription pain medicines too often can cause more headaches later.

Some types of behavior therapy, such as relaxation exercises, might help to prevent migraines in some people. However, these might not help young children, and health insurance might not pay for them.

Is there anything I can do to keep my child from getting a migraine? — Maybe. Things that might help include good sleep habits, regular meal schedules, and regular exercise.

In some cases, migraines can be 'triggered' or set off by certain foods or things that children do. Some possible headache triggers are:

• Skipping meals
• Not drinking enough fluids
• Sleeping too much or too little
• Stress
• Certain foods

If you can figure out what is triggering your child's headaches, you might be able to help your child avoid those triggers. To find possible triggers, keep a headache diary for your child. In the diary, write down every time your child has a headache along with the following education:

• The times it started and ended
• Where in the head the headache was, for example, left side, right side, both sides, or behind the eyes
• How the headache felt, for example, "pounding" or "sharp"
• What your child ate and did before the headache started
• How bad the headache was – Using the FACES pain scale can help (figure 1)
• What you did to try to help, for example, having your child rest in a dark room
• What, if any, medicine you gave, including the name of the medicine and how much you gave
• Any other symptoms your child had with the headache, for example, numbness in his or her lips

After you have been keeping a diary for a while, check to see if there are any foods or events that seem to bring on a headache. Then, try avoiding those triggers to see if headaches happen less. Share the diary with your child's doctor or nurse. It can help him or her understand your child's headaches and choose the best treatment for your child.