Childhood migraine is quite common. In fact, a number of studies show that just over one in ten school aged children suffer migraine, which is about the same rate of prevalence as the adult population. Migraine has been reported in toddlers as young as 18 months. Even newborns may suffer migraine. Without adequate treatment, around half of children with migraine will continue to suffer as an adult.

Migraine frequently goes undiagnosed in children and adolescents, because often head pain is less severe than other symptoms such as feeling sick in the tummy and/or dizziness. Other signs may include a pale face with dark rings under the eyes; avoidance of touch, bright lights, loud noises, strong odours and ice cream as these may aggravate or trigger their pain. The child may display sudden mood swings, withdrawal, lethargy, irritability, learning difficulties, depression and anxiety.

Children and toddlers with migraine often have short concentration spans, which may affect their ability to learn and socialise, and their general quality of life. They are absent from school twice as often as children who don’t have migraine and often miss out on social, sport and recreational activities.

Tender painful fibrotic nodules in the soft tissues of the scalp, including in the muscles that attach to the head, are frequently found in children with migraine. Studies have found that these tissues have direct connections with the nerves that supply various parts of the brain including the membranes (meninges) and blood vessels that supply the brain. Pain associated with these fibrotic changes can disturb the normal activity of these nerves, which is believed to be a main underlying mechanism causing migraine.

It’s common for babies to be born with strained scalp and head muscles, strained during labor and/or whilst in the uterus. In most cases, these spontaneously heal over time. In a significant number these may be maintained or worsened by aggravating factors. For example, pain associated with strained head tissue may lead to excessive crying, which can further strain and maintain the condition.

There are a myriad of ways for a child’s to overload their scalp and head muscles. It may be associated with excess sucking of their thumb or pacifier; constantly holding their mouth tightly shut, for example when holding back from biting a newly arrived sibling who has suddenly taken away much attention; frustration; and prolonged concentration periods associated with overachieving at school.