More threads by David Baxter PhD

David Baxter PhD

Late Founder
Don't Ignore Migraines in Teenagers:
Study Shows Teens With Severe Headaches Aren't Getting Treatment

By Linda Little, WebMD Medical News

April 5, 2006 (San Diego) -- If your teenager constantly complains of a headache, don't write it off as an excuse to skip a day of school or avoid the day's chores, Florida researchers advise.

A nationwide study of 18,714 adolescents aged 12 to 19 shows that migraine headaches in teenagers are common, disabling, and substantially undertreated.

"If your adolescent has a headache, they more than likely are really having a headache," says researcher Paul Winner, MD, director of the Palm Beach Headache Clinic and professor of neurology, Nova Southeastern University, Fort Lauderdale, Fla. "Headaches are causing a lot of disability in the nation's youths."

Findings of a nationwide survey not only show that a large number of adolescents have migraine headaches, but they aren't receiving appropriate treatment for those debilitating headaches. The results were presented at the American Academy of Neurology (AAN) 58th annual meeting.

The study found that for a one-year period, 5% of boys and 7.7% of girls reported frequent migraines.

Migraine Medications
About 60% of those with migraines were using only over-the-counter medications to alleviate the symptoms. Only 17% used prescriptions drugs for migraines and 22% used both prescription and over-the-counter medication.

Almost one-third of adolescents with migraines met the criteria of severity and frequency of headache for taking medications to prevent migraines; even so, the majority was not receiving those medications.

Thirty-one percent met the criteria to warrant preventive therapy. Yet of those who met the criteria for preventive therapy, only 19% had used preventive medicine previously and only 10.6% were current users.

"There was a lot more disability than what we expected," Winner tells WebMD. "The fact that 31% of these kids were eligible for preventive care is enormous. That represents a lot of pain, suffering, and loss of school and family activities."

Increasing Frequency of Migraines
The study sent out questionnaires to 120,000 households that were representative of the U.S. population. Surveys were returned by 77,879 households that yielded data on 18,714 adolescents. Migraine cases were established by national guidelines on headache criteria. Migraine sufferers who were candidates for preventive therapy were determined by an expert panel of neurologists using AAN guidelines.

The researchers found that the frequency of migraine headaches among adolescent sufferers continued to "rapidly" increase. "The child initially might have one or two headaches a month and then a couple of years later have 10 or 15 headaches a month," Winner says. "They seem to transition quickly. These kids need help."

The study also showed that girls starting at age 14 and both male and female adolescents from poorer families earning less than $22,500 annually had higher rates of migraine headaches, according to Winner.

Advice for Parents
Winner advises parents of children with frequent headaches to seek help from their doctors and that adolescents talk with their parents and doctors about frequent headaches. "The child needs to know that it isn't normal to have a really severe headache," he says. "That is not a normal state."

Migraine headaches are less common in childhood and reach higher levels in adulthood, so the percentage of adolescents with migraines isn't surprising, notes J.D. Bartleson, MD, associate professor of neurology, Mayo Clinic College of Medicine.

"What is more surprising is that migraine headaches in adolescents are underrecognized and undertreated," Bartleson tells WebMD.

Bartleson says there needs to be better public awareness that both acute symptomatic and preventive treatment is available for migraine headaches.
I suffer from migrains, I've been getting them since I was about 12. They get so bad that I would miss so much school. funny thing is and at the time I didn't know any better but my mom took me to the doctor and he prescribe birth control. weird. After a while they quit working and as I got older and went threw a bunch of medications we finally found one that worked. Imatrex, I would have to give my self shots. and to this day I still get them. Nice to know information about teens and migrains.


I've always gotten headaches/migraines, and now, my 11 yr old son gets headaches, too. I can usually tell when he's really got a headache or a migraine, his behavior is definitely more mellow if it's a true migraine. I don't ignore headaches for MY kids! They tell me they've got a headache-- they've got one. I've found if I address the headache early (rest, dark room, tylenol/aleve/excedrin, etc) quiet room, & sleep, sometimes we will catch it early enough. We haven't gone for a prescription yet, but it may come to that -- for both of us! But I'm eternally grateful (to God, I guess!) that I don't get migraines like some do, with the vomiting and they last for days-- and the PAIN. Gheesh-- mine are painful enough! Vomiting on top of it, would be horrible. Nuff said-- I agree w/ the article. I believe migraines are underdiagnosed in children, and if parents would sometimes take a little more proactive action against a POTENTIAL migraine coming on,(and not dismiss it as a kid just trying to get out of chores or school-- I mean, REALLY look at your kids and assume they are telling you the truth, unless you've a proven history of "false illness") it's possible to "head 'em up at the pass" before they truly take hold and it's too late!--Poohbear

David Baxter PhD

Late Founder
LostChild, the reason the doctor prescribed birth control pills was to stabilize hormone fluctuations a bit - in younger women, that is a common cause of migraine.


Migraine has been commercialized by TV ad campaigns to suggest that just about any headach is a migraine.? As we know, migraine is a very specific type neurological event, manifesting itself as a one sided headache, but often accompanied by nausea, vomiting, sensitivity to light, sound and smell.

Most over the counter pain relievers such as aspirin, acetomenophen (Tylenol etc) or even NSAIDS such as Advil might relieve symptoms temporarily, but usually result in a rebound effect where you need to keep taking the analgesic pain reliievers to prevent a headache.

Recent treatment strategies have produces very specific medications? (a class of medications known as triptans) which are thought to work on the source of the migraine, at the neurotransmitter level in the brain, and to actually abort the migraine.

Only a neurologist can diagnose migraine, so one should not assume their headache is a migraine just because it sounds like what is described in the TV commercial.

People who experience mograins need to keep a diary of what they consume and of their activities over a period of months, to assist the neurologist in the diagnosis..

Migraine triggers include:

Food & food additives?
? Alcohol (especially red wine), caffeinated beverages, nuts, nitrite/nitrate-preserved foods (hot dogs, pepperoni), smoked or pickled foods.?
? Strong or glaring light. Flickering lights from TV or computer screen, strobe or laser lights, or reflections.?
? Intense, specific food odors, cigarette or other smoke, perfumes, cleaning products.?
? Migraine attacks often occur after stress - especially on weekends and holidays. Many people mistake these as tension headaches.?
Weather Changes?
? High humidity, atmospheric pressure changes, rapid temperature fluctuations, and exposure to extreme heat or cold may bring on migraine attacks. Many people mistake these for "sinus headaches."?

Changes in sleeping habits
? Too little, or more often, too much sleep can trigger migraines.?
? Any change in eating habits, missed meals, change in schedule or dieting.?
Loud noises/sounds?
? Sudden or prolonged loud noises.?
? Reaction to motion sickness.?
? Having more (and sometimes even having less) caffeine than you are used to can trigger migraines.?
Hormonal Fluctuations?
? The frequency of women's migraines is sometimes said to be related to hormonal fluctuation, particularly with regard to estrogen. In many women, migraines begin just prior to, or during, their monthly menstrual period, or during treatment with artificial hormones such as birth control pills or estrogen replacement therapy.?

To help identify which triggers affect you, keep a migraine diary for several months...the longer the better.? Every time you experience a migraine, write down what you ate that day or what other conditions existed prior to the attack.

After a while a profile emerges that can help you avoid the triggers that affect you.

If you are interested in migraines in teens or children you may wish to read? Guidelines for Treating Pediatric Migraine from the American Academy of Pediatric Neurology

Also this article: Migraine-A Pediatric Perspective

General overview on migraine? ? ? ?

Click here for Migraine on MedicineNet
Did you know that you can be suffering from a migraine without having the headache symptoms??

I have always suffered from migraines, I think the first one I had was a sports day in grade one. However, about 6 years ago, I had two days of weirdness with my eyes, I was sick, (nausea - which for me generally accompanies a migraine anyway) but had blind spots in my right eye, which was distorting what I could see, for instance, if I looked dead centre at a face, I saw the right side of the face, but not the left... now... I didn't see a blank left hand side of the face, it just wasn't there... (like... nothing was) and then, when I looked out of a top story window at my friend, when I looked at him, I could only see his feet, (cause of the angle) however, I could see the whole of him through my peripheral. Doctors said that I was experiancing a migraine. I just found that interesting.


I was on many meds as a child due to respiratory problems and it had an impact on my heart and development of cardiovascular system. So as a teenager, I had pretty severe migraines.

Usually, when one struck, I had it for 3 to 4 days. I used to pop aspirin like it was candy, after a while my doctor gave me an Rx for Fiorinal. However, my mother would steal all my pills (and take them herself) so I mostly stayed on Aspirin and refused to get refills. At age 16, I developed 3 large bleeding ulcers.

After I got better, I switched to Tylenol #3. But because my mother still stole my drugs, I stopped that too and went to the over the counter Tylenol (or Tylenol #1) :D

However, I found that it was my hypoglycemia and bad sleeping habbits that were part to blame. So after changing those, I didn't need the meds as much and migranes happen very very rarely now. I've also developed aversion to drugs. LOL I also get weird vision when a migraine is coming (but no blind spots)


I also get weird vision when a migraine is coming

I believe this is referred to as an aura, and in some people is a precursor to migraine activity

Neurologists who treat people with migraine will usually ask them to maintain a log of their activities around the time they experience a migraine to identify the triggers. Once the triggers can be identified, they can be avoided as much as possible as a preventative measure.

Since weather changes and drop or increase in barometric pressure can act as a trigger in some people, it's difficult to avoid these, but medications have been developed that are specific for treating and in fact abort a migraine episode.

The class of meds known as triptans have been shown to be effective in treating and in fact to arrest the onset of a migraine episode when the medication is taken as early as possible when the onset of a migraine is felt.

Medications used for symptomatic relief, like aspirin, acetaminophen (Tylenol), ibuprofen (Advil), or any other pain reliever have been shown to provide temporary pain relief for migraine, but one soon develops a tolerance to them, needing more for the same pain intensity. In addition the use of symptomatic pain relievers in migraine results in the phenomenon known as rebound headaches, where the headache returns when the medication is the person now has to take the pain reliever continually to avoid another migraine.

Anyone afflicted with migraine would be advised to consult a neurologist known to treat migraine, as migraine is a neurological event, and follow the treatment regimen recommended by the specialist for the most effective and safest relief from migraine.
Also, if you suffer migraines and you're a woman, that decreases the number of contraceptive pills you should be taking. The rest would otherwise increase the risks of strokes.


if you suffer migraines and you're a woman, that decreases the number of contraceptive pills you should be taking. The rest would otherwise increase the risks of strokes


I do not believe this information is correct based on my understanding of contraindications and warnings in connection with oral contraceptives

Oral Contraceptives are not contraindicated in women who experience migraine, however manufacturers of OC's do include migraine in the warnings. Contraindications are absolute, whereas warnings are subject to evaluation based on the woman's medical history and if it is decided the woman will use OC's and experiences migraine, she would be followed more closely by her physician.

Migraine headaches while taking Oral contraceptives may cause fluid build-up and may cause these conditions to become worse; however, some people have fewer migraine headaches when they use oral contraceptives

In the days when OC's were first marketed, the dose of estrogen and progestin were very high, and many women experienced an increase in migraine while using these combination OC's in the 1960's.

These dosages have not been used since the early 1970's and migraine is not a major issue in women taking OC's.

There is a general rule in connection with Oral Contraceptives, and that is every pill must be taken, preferably at the same time every day to maintain effectiveness. particularly with todays very low dose preparations.

The regimen as explained by one's physician should be followed to the exceptions, otherwise effectiveness is compromised.

Your reference to stroke is on the right track, but not in connection with migraine and OC's.

History of/or actual thrombophlebitis or thromboembolic disorders; history of/or actual cerebrovascular disorders; history of/or actual myocardial infarction or coronary arterial disease;

is one of the universally accepted absolute contraindications for OC's. A woman with a history of blood clotting disorder or coronary artery disease is not a candidate for OC's.
Ok, thanks, however I think I may be a little misunderstood, what I meant by "that decreases the number of pills" I meant the number of types of different pills - I totally stress that when you use OC's, you do need to try to be taking all of them at the roughly the same time (depending on the type).
I only had a 'top of the ice burg' kinda idea anyway. It was the warning from my new doctor after being on a certain type with my old one.


You're right, Phoenix, I did misunderstand your statement about decreasing the number of pills. Of course I realize now you meant the selection of brands and especially dosage type OC's is reduced.

Thanks for the clarification :)
Dr. Baxter,
thanks for posting this article...I e-mailed it to my mom and I think she may take me more seriously now when I tell her I have a migraine...even though she suffers from them she also just thought I was being over dramatic (even though I had all the physical symptoms)...anyway she e-mailed me back and told me I should bring it up w/ my dr. before I leave for college (yeah I live w/ my mom but we still communicate through e-mail)...anyway thanks again for posting this important article... :)



Glad to hear that you have communicated with your mother about the issue of migraines and that she seems to understand.

Good Job.

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