How do I keep a headache diary for a child or teenager?

Write down each headache with its start and end time, where it hurt, how the child behaved or described it, any other symptoms and any medicine given. Classification criteria note that in under-18s attacks can be shorter, pain is more often on both sides, and light and sound sensitivity may have to be inferred from behaviour, so those details are worth noting. Only a doctor can diagnose.

Facts checked on · Written by Alfonso Matos, the developer of MyGrain.

How migraine can differ in children

ICHD-3 notes that in children and adolescents (under 18) migraine attacks may last 2 to 72 hours, and that evidence for untreated attacks shorter than 2 hours has not been substantiated. NICE gives a duration of 1 to 72 hours for young people aged 12 to 17. ICHD-3 also says that migraine headache in under-18s is more often on both sides than in adults, that one-sided pain usually appears in late adolescence or early adult life. It also says that migraine headache is usually frontotemporal, and that headache at the back of the head is rare in children and calls for diagnostic caution. The WHO notes that children typically experience migraine of shorter duration and that abdominal symptoms are usually more prominent.

What to write down

NICE says a headache diary should include the frequency, duration and severity of headaches, any associated symptoms, all prescribed and over-the-counter medications taken to relieve them, and possible precipitants. For a child, the same items apply, with some adjustments suggested by the criteria:

  • Start and end time, since attacks may be shorter than in adults.
  • Where it hurts, in the child's own words, and whether it is on one side or both.
  • Behaviour: ICHD-3 says that in young children sensitivity to light and sound may be inferred from behaviour, so note what you see the child do.
  • Stomach symptoms, because the WHO notes they are usually more prominent in children.
  • Medicine given, with the date and the name of the drug.

Aura in children

ICHD-3 describes visual aura as a gradually spreading zigzag figure or blind spot, and notes that in children and adolescents less typical bilateral visual symptoms occur that may represent an aura. If your child describes seeing something unusual before or during a headache, note what, in which eye or both, and how long it lasted.

Sharing it with the doctor

Ask your child's doctor how long to keep the diary and whether they want anything else recorded. In MyGrain you can log each episode with its type, intensity, duration, symptoms and treatments, and take that record to the appointment. MyGrain does not diagnose: only a doctor can diagnose a headache disorder in a child or teenager.

Frequently asked questions

How long do migraine attacks last in children?

ICHD-3 says attacks in children and adolescents under 18 may last 2 to 72 hours. NICE gives 1 to 72 hours for young people aged 12 to 17. The WHO notes that children typically experience migraine of shorter duration.

Is the pain on one side in children?

Not always. ICHD-3 says migraine headache in under-18s is more often on both sides than in adults, and that one-sided pain usually emerges in late adolescence or early adult life.

Can a young child say they are sensitive to light and sound?

Not always. ICHD-3 notes that in young children sensitivity to light and sound may be inferred from their behaviour, so it is worth describing what you observe.

Can a child have symptoms in the stomach?

Yes. The WHO notes that abdominal symptoms are usually more prominent in children with migraine.

Sources

Classification criteria, NICE guideline and the WHO, re-read on .

Medical disclaimer. MyGrain is a self-tracking diary, not a medical device. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or another qualified health professional with any question about a medical condition.
Download on theApp Store Get it onGoogle Play

More guides