Sunday, July 13, 2014

Migraine Headaches

Headaches are a common health problem in elementary schools, and are ranked as the fourth most common concern in that age group (Allen, Mathews, & Shriver, 1999; Özge et al., 2013), and are the most common neurological problem in adolescents (Marcelo et al., 2012; Özge et al., 2013). Migraine headaches are one of the two most common types in children and are characterized by a moderate to severe intensity of pain and are often accompanied by nausea and sensitivity to noise and light (Allen et al., 1999). Routine activity, such as school-related tasks aggravate the headache. Migraine headaches can be triggered by stress, such as demands originating at home or school, exercise, emotional distress, lack of good quality sleep, food allergies, food additives, diet, and hormonal imbalances (Mitchell et al., 2011).

   Impacts on Adolescent's Educational Experience, Social Functioning, and Families

When children endure chronic headaches, they are more likely to develop emotional and behavioral problems if they do not have coping strategies effective for their age group (Allen et al., 1999). Additionally, adolescents who experience chronic headaches have an increased risk of developing depression, anxiety, and somatic pain. That said, most adolescents with chronic headaches show no significant psychological issues as a result of the headaches. In some children, however, chronic headaches can cause social withdrawal, impaired academic achievement because of increased school absences, and an lower threshold for stressors in the school environment (Allen et al., 1999).

Migraine sufferers have an unusually high degree of social anxiety (Marcelo et al., 2012). Kowal and Pritchard (1990) found that some, but not all, migraine sufferers were more shy and sensitive and experienced more frequent psychosomatic complaints. If migraines are a result of social anxiety, interventions that resolve underlying issues could be beneficial. Social anxiety often begins at 10-16 years of age and causes a range of social deficits in the academic environment, as well as in the development of social relationships (Marcelo et al., 2012). Adolescents with social anxiety are less likely to complete their education and have poor adjustment outcomes. When migraines begin in this age group, it is prudent to screen the adolescent for social anxiety (Marcelo et al., 2012).

                                                 Non-Medical Treatments

Adolescents can self-monitor their headaches as part of an assessment to determine the headache's triggers. For example, if an adolescent's headaches started after lunch on school days, it is reasonable to evaluate the adolescent's diet for food additives, various trigger foods, or food allergies. Allen, Mathews, & Shriver (1999) found a paucity of research on managing headache triggers, so families, school personnel, and even the adolescents themselves, must be creative when circumnavigating the foods or other triggers that appear to be causing the headaches. Once an adolescent understands the triggers he or she needs to avoid, they can self-manage with some help in finding alternatives to the problematic foods or other factors that are causing the migraines. Triggers other than foodstuffs may be underlying the migraines as well. When an adolescent keeps a diary for a few weeks, it is easier to identify the migraine's antecedents.


Allen, K. D., Mathews, J. R., & Shriver, M. D. (1999). Children and recurrent headaches: Assessment and treatment implications for school psychologists. School Psychology Review, 28(2), 266–279.

Kowal, A. & Pritchard, D. W. (1990). Psychological characteristics of children who suffer from headache: A research note. Journal of Child Psychology and Psychiatry, 31(4), 637–649.

Liakopoulou-Kairis, M., Alifieraki, T., Protagora, D., Korpa, T., Kondyli, K., Dimosthenous, E., & Kovanis, T. (2002). Recurrent abdominal pain and headache: Psychopathology, life events, and family functioning. European Child & Adolescent Psychiatry, 11(3), 115–122.

Holden, E. W., Gladstein, J.U., Trulsen, M., & Wall, B. (1994). Chronic daily headache in children and adolescents. Headache: The Journal of Head and Face Pain, 34(9), 508–514.

Masruha, M. R., Lin, J., Minett, T. C., Vitalle, M. S., Fisberg, M., Vilanova, L. P., & Peres, M. P. (2012). Social anxiety score is high in adolescents with chronic migraine. Pediatrics International, 54(3), 393-396. doi:10.1111/j.1442-200X.2011.03555.x

Mitchell, N., Hewitt, C., Jayakody, S., Islam, M., Adamson, J., Watt, I., & Torgerson, D. (2011). Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches. Nutrition Journal, 1085. doi:10.1186/1475-2891-10-85

Özge, A. A., Sasmaz, T. T., Bugdayci, R. R., Çakmak, S. E., Kurt, A. Ö., Kaleagasi, S. H., & Siva, A. A. (2013). The prevalence of chronic and episodic migraine in children and adolescents. European Journal Of Neurology, 20(1), 95-101. doi:10.1111/j.1468-1331.2012.03795.x

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