Headache and migraine in children

Chronic or recurrent headaches in children - not uncommon

Already at preschool age 20% of the children are affected, by the end of primary school more than half. A study of almost 7000 pupils shows that by the age of 12, around 90% of children experience headaches. Among the chron. Headache one distinguishes 2 large groups: Migraine and tension headache.

childhood migraine

Migraine in children differs from migraine in adults in the following characteristics:

  • Among the accompanying symptoms typical of migraine (nausea, vomiting, sensitivity to noise and light), nausea and vomiting are often the most prominent in children. However, some children also complain of recurrent abdominal pain.
  • In some children, the migraine manifests itself in the form of regularly occurring
  • Dizziness attacks with nausea and vomiting, without headache. Such complaints must be clarified by a doctor in any case to exclude other causes
  • The pulsating or throbbing pain is usually not limited to one side of the head, but affects both sides and the forehead.
  • Attacks are shorter than in adults, sometimes lasting as little as two hours or possibly even shorter
  • Often the child falls asleep in the course of an attack and after waking up is largely without symptoms

Children may also experience neurological deficits, the so-called aura, shortly before an attack. These include flickering vision or flashes of light in front of the eyes, sensory disturbances in the hands and arms or speech disorders. Children often report "fantastic images" (Alice in Wonderland syndrome).

Typical causes of migraine

Migraine has many causes. However, it is undisputed that there is a genetic disposition to this type of headache. It is not uncommon for parents to also report a migraine that occurred early in childhood or adolescence. Typically, this is the time of puberty or shortly before.

However, in addition to genetic disposition, there are also a number of triggering factors, such as

  • certain foods, especially those containing tyramine. Tyramine is produced by the breakdown of proteins and is often a natural ingredient in foods that involve steps such as fermentation, such as many cheeses and chocolate. It is also an ingredient in bananas.
  • Irregular sleeping habits
  • overstimulation by e.g. electronic media
  • Weather change
  • Changing light conditions of the seasons
  • Psychological stress, e.g. due to excessive demands at school

Tension headache

Unlike migraine, tension headaches do not differ between children and adults.

  • The pain is dull-pressing to pulling and not pulsating.
  • The pain usually occurs on both sides of the head (It often spreads from the neck to the forehead or from the forehead to the neck and also affects the eyes or cheeks).
  • The pain is of mild to moderate intensity
  • The pain does not increase with physical activity
  • The typical migraine symptoms such as nausea, vomiting, sensitivity to light, noise and smell are absent. Occasionally, mild nausea may occur.

Typical causes of the tension headache

The tension headache occurs rather slowly and increasingly during the day and has no aura and also not the sudden onset of a migraine. On the other hand, it often lasts longer. According to our observations, the following factors in particular play a role here psychological factorsnamely school stress or family conflicts, play a special role.

In addition, the following causes can be observed:

  • insufficient fluid intake, for example after sporting activity
  • malnutrition
  • Noise, no possibility to retreat
  • Constant sprinkling through electronic media

As you can see, the causes overlap and sometimes migraine and tension headache also come together, merge into each other and are almost impossible to separate.


The diagnosis is made through a careful interview of the child and parents, a neurological examination, and the EEG posed. Only rarely, when the headache is very atypical, associated with neurological deficits and especially when there are disturbances of consciousness, are imaging techniques such as the Magnetic resonance imaging (MRI) required.