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Key to Migraine Relief for Children is Prevention

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Most of the time when we think about migraines we think of adults, but doctors say that migraines often go misdiagnosed in children. Pediatric neurologists say migraines in children are actually quite common. Studies show migraines occur in 5 percent of children under 10 and in 10 percent of teens and preteens.

"I'm talking about recurrent headaches, where they're well in between them, but they're bad enough that they are either vomiting or they consistently have to go to sleep, turn off the lights," said Dr. Wendy Mitchell at Children's Hospital Los Angeles.

The Food and Drug Administration has yet to approve a drug for children, so experts say the focus has to be on prevention. "They know if they stay up late, and they're late in the morning, they skip breakfast, they don't like whatever the school's serving for lunch, so they haven't eaten and then they get home at 4 o'clock and then they have a terrible headache," said Mitchell. If the episodes happen occasionally, Mitchell recommends giving your child a caffeinated beverage accompanied by acetominophen or Tylenol. If it happens much more often, parents should keep a headache diary to track the triggers and talk to their doctor about a pediatric pain management program.

Kids with migraines often grow up to be come adults with migraines. That's why experts say learning to prevent them and find ways to manage them early will help keep them under control.

Source: abc.com

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Migraine Triggers Not As Accurate As We May Think

There has always been a lot of talk around migraines about triggers and discovering what cause your migraines, be it wine, chocolate, cheese, perfumes. . . the list goes on and on, but new research suggests that we may actually have no idea what triggers our migraines.  According to Wake Forest Baptist Medical Center, migraine triggers are difficult to determine without undergoing more formal testing.

Study researcher Timothy T. Houle, Ph.D., assistant professor of anesthesia and neurology at Wake Forest Baptist Medical Center said that, "correctly identifying triggers allows patients to avoid or manage them in an attempt to prevent future headaches. However, daily fluctuations of variables - such as weather, diet, hormone levels, sleep, physical activity and stress - appear to be enough to prevent the perfect conditions necessary for determining triggers."

Two studies were published in the journal Headache and in one of them it was noted that there must be three criteria in order for something to be reliably identified as a migraine trigger. 

  1. "Constancy of the sufferer"
  2. "Constancy of the trigger effect"
  3. "Constancy of the trigger presentation"

The other study concluded that is was difficult to pinpoint what exactly the trigger was. 

Even after the countless articles outlining migraine triggers, we still cannot blame them solely on that.

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Research Shows Migraine Sufferers Have Brain Abnormalities

A recent article in Medical News Today announces that patients who suffer from migraines have reduced cortical thickness and surface area in pain-processing regions of the brain, compared to individuals who never have migraines. 

Italian researchers explained int he journal Radiology that brain abnormalities in migraine sufferers may be either present at birth, or develop overtime. 

Previous studies found atrophy of cortical regions in the brain related to pain processing. It was suggested that the deterioration was due to chronic stimulation of those areas, if people have persistent pain, there will be more stimulation in the area.

The 'cortical regions' refer to the cerebral cortex., often call "the cortex" and it is a thin layer of grey matter that covers the surface of each hemisphere of the brain. It is responsible for the processes of memory, perception, thought, pain, and serves as the seat of social abilities, language, problem solving and advanced motor function. 

Massimo Filippi, M.D., director of the Neuroimaging Research Unit at the University Ospedale San Raffaele and professor of neurology at the University Vita-Salute's San Raffaele Scientific Institute in Milan, both in Italy, said:

"For the first time, we assessed cortical thickness and surface area abnormalities in patients with migraine, which are two components of cortical volume that provide different and complementary pieces of information.

Indeed, cortical surface area increases dramatically during late fetal development as a consequence of cortical folding, while cortical thickness changes dynamically throughout the entire life span as a consequence of development and disease."

Dr. Filippi and team used MRI (magnetic resonance imaging) to obtain T2-weighted and 3-D T1-weighted brain images from 81 volunteers - 63 of them were chronic migraine suffers while the other 18 never suffered from migraines (healthy controls). Using a special software program and statistical analysis, they estimated each participant's brain's cortical thickness and surface area and correlated the measurements with their clinical and radiologic characteristics.


They found that:

  • Those with migraines had thinner cortexes and smaller surface areas in regions related to pain-processing compared to the healthy controls
  • Cortical surface area abnormalities were more pronounced and distributed than cortical thickness abnormalities among the participants with migraines

 

Article from www.medicalnewstoday.com

 

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Vitamin B to help Migraine Sufferers

Researchers believe vitamin B and folate supplements will reduce the frequency and severity of migraines in 20% of sufferers.  Scientists from Griffith University are close to a new treatment for severe headaches that consists of vitamins B and folate supplements. 

This remedy could help the 20% of sufferers whose condition is genetic. Griffith postdoctoral researcher Bridget Maher says that the remedy "basically reduces the frequency and severity of migraines."

It has been found that one in five people prone to migraines have an enzyme that doesn't work as well as other people. Maher said, "By supplementing them with vitamin B and folate you can get around the enzyme defect."

The team at Griffith is working on the correct dose of the supplements and Maher says the treatment could be on the market within the next few years.  Since some people don't respond to current migraine remedies, the new research could significantly help those with a genetic predisposition to the condition.

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Migraines and your Children

Some are now saying that migraines in children can in some way be linked to behavior disorders.  One study on children and migraines, published in the journal Cephalagia and involving 1,856 kids from ages 5-11, found that children with migraine headaches had a significantly higher risk for behavior disorders. The finding is in line with results from previous studies showing that children with migraines have a higher risk for depressive disorders, anxiety, and behaviors such as hyperactivity and attention problems.

Behavior problems could be a trigger for migraine attacks in children, or they could be a result of migraines. "It is hard to tease out the link between problems like depression and hyperactivity from migraine because all these conditions are common in children," says Andrew D. Hershey, MD, PhD, associate director of neurology research and professor of pediatrics at Cincinnati Children's Hospital in Ohio. "Both behavior problems and headaches need to be checked out. The most important thing is to realize that children do get migraines. In fact, migraines are one of the top five childhood disorders, even more common than childhood asthma."

Migraines can start at any age, for boys they are more common before age 7 and for girls after puberty they are most common.

Here are some signs you can look for to help recognize migraine in children:

  • A pounding type of headache - younger children may have pain on both sides of the head or across the forehead.
  • Pain that limits the child's activity or is made worse by activity.
  • Pain that is moderate to severe (most migraines are more moderate than severe)
  • A headache that lasts from one to 72 hours
  • A headache that comes with nausea or vomiting
  • A headache that's made worse by sound or light

Very young children who can't complain of pain may become quiet, pale, and sweaty. Children may have visual changes before a migraine starts, called a migraine aura. 

To minimize migraines in children, Dr. Hershey recommends that parents make sure their child:

  • Drinks enough fluids. Dehydration is a common trigger
  • Avoids caffeine. Caffeine in soda or energy drinks may be a trigger
  • Eats healthy foods and eats regularly. Skipping meals is also a common trigger
  • Gets enough exercise. Exercise reduces stress, which could be a trigger
  • Gets enough sleep. Most kids need nine hours or more
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