8 day headache

Q: My identical twin sons, 9 years old, both suffer with migraine (one more frequently than the other). The symptoms are severe headache and vomiting. Sometimes, if they take a painkiller quickly and go straight to sleep for an hour or so, they can by-pass the vomiting stage. The main triggers seem to be tiredness and/or emotional upsret. For example, if one has been crying about something (even minor) in the morning, a migraine will often follow in the afternoon. My husband is a migraine sufferer.

Both my sons are keen competitive swimmers. The one who suffers most had to pull out of an important gala last weekend because of a migraine. I try to get him to have a sleep in the afternoon before a gala, but if he is excited or nervous, he finds this difficult. I try to make sure he has plenty of slow-releasing carbohydrate that day and that he drinks plenty of water. Is there anything else I can do to help him prepare for a competition so that he doesn't get a migraine before or during one? I have also heard that children can grow out of migraine in adolescence. Is this true?

A: It sounds as though you are doing many sensible things in order to avoid these attacks for your sons. One additional thing to consider is to ensure their blood sugars are maintained especially after the swimming where these levels become depleted after using so much energy. It is as important to maintain these levels as well as drinking plenty of water. A high energy drink or a glucose tablet during a break might be helpful.
Sometimes taking a daily preventative treatment can help to reduce the severity of the symptoms and/or frequency of attacks. You need to discuss this option in more detail with your doctor.

Children can grow out of migraine, particularly boys, but this isn't guaranteed. If they can do their best to avoid some or all of their trigger factors, they may be able to control the attacks and not be so badly affected should a migraine occur.
Evidence suggests that if migraine can be effectively managed in childhood it has less of an impact on the adult lives of sufferers.

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Q: My 5 year old had all the symptoms of a migraine the other night with the residual effects the next morning. As a lifetime (since 4) sufferer of them I know the signs pretty well. The only other symptom he had was 99 degree fever with it. I just happened to check it because of the vomiting. My mum doesn't ever remember me having a fever with any of my headaches, so I was wondering if this can be one of the symptoms.

A: Migraine sufferers do sometimes report temperature fluctuations as one of the symptoms of their attacks. As your son has fully recovered it is unlikely that his high temperature was an indication of anything more serious. However you may wish to discuss this with your doctor.

Migraine can be triggered by other conditions which may have caused the high temperature, particularly if it is viral in nature.

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Q: My son has been suffering from migraine since he was 3 years old. He was given medication to prevent them which helped for a while. They subsided for about a year but now they have come back with a vengence. They were always at teatime but now during the night he has had one 3 times over the last 2 weeks. He has a nasty headache and tummy ache for about an hour then vomits, goes to sleep and then he is OK. He is 6 years old now. Do you think it's worth going back to the doctor? He has all the tests and nothing has been detected with regards to what is triggering the attacks, apart from a scan, although I have told them that there is a history of brain tumours in the family.

A: Yes, it is definitely worth seeing the doctor again. They will be able to advise you with regards to further tests. Less than 5% of people who consult a doctor about headache have a life-threatening or sinister condition, and often in these cases there are other symptoms as well as the headache. Do mention your concerns and, if you feel it appropriate, ask for a scan for peace of mind.

If your son is no longer taking the preventative medication, you can speak to the doctor about re-starting it to see if it helps to keep the attacks away again. If he is still taking the treatment, then it would appear this is no longer having the desired effect on his migraine and there are other treatments which may work better for him. Migraine does tend to evolve and it is quite common for the medication to require review.

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Q: My son is waiting to see a neurologist. He has classic symptoms of migraine but my daughter has an arachnoid cyst and other structural anomolies of the brain, so I have insisted that he sees a neurologist. My question is: Can equipment at the local park start a migraine? For the last couple of times we have been to the park, he has become unwell after being on something that spins round very quickly.

A: Migraine triggers are numerous and varied. It is possible that whilst at the park your son has become excited and over-exerted himself, in addition to going on the rides that are particularly fast and spin round, perhaps causing him to feel particularly dizzy and sick. Try limiting the time he is at the park and discourage from using the equipment that spins and see if he is OK. As he continues to be well you can try to gradually reintroduce some of the equipment - although you may find if he has a sensitivity to motion he may be better to avoid this altogether. There are plenty of other non-spinning games he can play to avoid the attacks.

Identifying triggers can be lengthy but can be very worthwhile as they can often be easily avoided to prevent attacks.

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Q: We are very worried about our 8 year old son. Most nights at the moment he seems to get really bad headaches and says that the point of pain is at his temple. Calpol seems to take the pain away and the doctor has made an appointment for us at the hospital. He has no other symptoms, no sickness or tummy ache - just this headache. He says it starts slowly and builds up and sometimes he gets very upset with it which doesn't help at all. If he gets a headache in the day, it is nowhere near as bad as the night-time one and tiredness does seem to make it worse.

A: You are right to consult a doctor and get a hospital referral to confirm the diagnosis. Migraine does not normally occur daily. it may be that your son has another condition, Cluster Headache, where very intensive headaches occur sometimes severeal times a day and often wake sufferers from sleep. For mroe information on Cluster Headache please visit www.ouchuk.org.

If it is confirmed as migraine, it may be helpful to seek a referral to a migraine clinic. Symptoms can vary so much between sufferers, particularly how migraine affects children compared to adults.
Often with migraine you can identify particular triggers which can cause the attacks. With the attacks occuring during the night, have you reviewed his sleeping pattern and/or behaviour? It is important to keep to a regular bedtime routine and ensure he has sufficient to eat and drink before going to bed. Some children eat their evening meal at 5 or 6 pm and then nothing until breakfast the next day which makes it a long time to go without food. Often a high carbohydrate snack before bedtime can help. A substantial breakfast is also important.
There is more information on identifying triggers and how to avoid them in other sections on this website which may be helpful.

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Q: My 4 year old son woke after an afternoon nap crying in pain with a headache. While getting him some pain relief he then got very distressed saying his eyes hurt. 10 minutes after his disprin, he was sick. He then recovered very quickly. Is it normal to feel better so quickly after being sick with a migraine?

A: Migraine in children can be much shorter than in adults. relief of an attack after vomiting is quite commonly reported by migraine sufferers of all ages. Why this happens is not fully understood; inducing or preventing the sickness seems to make no difference to the duration of the attack.

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Q: I have a 6 year old daughter who was diagnosed with migraine today. The doctor said to just give her Calpol until she is a bit older. Is there anything else I can do for her either herbal or complementary? I suffer from migraine as well and can't bear to think of my daughter having that much pain. Also can you send me some factsheets etc. for her nanny as she doesn't think young kids suffer from migraine.

A: There are various treatments available. Your doctor's suggestion of Calpol until she is a bit older is a good option. It is also useful to know that many children require no medication to treat their migraine and will often recover well with a short sleep in a dark, quiet place. Some children prefer to be left alone, whereas others need the reassurance of the presence of a parent or carer. In some children, vomiting will resolve the attack.
With regards to herbal or complementary treatments, vitamin B2 supplements have been shown to be effective for some children. However this is a preventative treatment which needs to be taken daily. Unless your daughter's attacks are very frequent or troublesome you may prefer to continue to treat attacks as they occur.

Keep a diary to identify what may be triggering the attacks (consider things like diet, dehydration, too much or lack of sleep, exercise, excitement, stress, etc.) and then try to avoid these. Simple lifestyle changes can make a real difference.

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Q: I have a 12 year old son who has started about 6 months ago to get migraine. He has about 2 or 3 a week and I want to try alternative medicine. I have tried feverfew 6x homeopathic tablets, but they didn't seem to help that much. I was wondering if I could try feverfew tincture on him for preventing the attacks?

A: Feverfew is suitable for children (and adolescents) from the age of 12 and can be used in the prevention of migraine. Taken every day, the tablet form should be used for a period of 90 days to assess the benefits. Most people prefer the tablet form as opposed to the raw leaves, as these are very bitter and may cause mouth ulcers.
Tincture is another option but is not recommended as the active molecules can be unstable in rigid form.
As with any treatment, it is important to check with your doctor or pharmacist with regards to its suitability.

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Q: My 15 year old daughter has been with a headache for 8 days, an MRI was done but I don't know the results yet. All she does is sleep. She has missed school because she cannot take the pain. I was told by her Doctor that it can be migraine; my husbands sisters all get migraines. I am really worried, how long do they last? She won't eat a lot and she feels tired.

A: It is good that this is being fully investigated and if anything sinister had been shown I'm sure the doctors would have contacted you quickly so that swift action could be taken if necessary. Migraine often runs in families, and with your husband's sisters also suffering with migraine, this diagnosis is reasonable once other possibilities have been excluded. Does she have any other symptoms, such as sensitivity to light, sound or smell, nausea or sickness, or changes in her vision (blind spots, zigzag patterns, for example)? The International Headache Society defines migraine in children as lasting between 2 and 48 hours, although sufferers may feel drained for a couple of days after that, wanting to sleep more and having a reduced appetite. However, migraine is a complex neurological condition which affects people in different ways - not everyone fits the text book definition.

If the diagnosis of migraine is confirmed, you will be able to work with the doctor on a migraine management plan for your daughter; there are effective treatments available, both to treat the attacks when they occur and to prevent them. Sometimes, simple lifestyle changes can make a real difference. You can try to identify potential triggers that may be causing the attacks and try to avoid them. Triggers such as types of food and / or drinks, too little water, too much or too little sleep, too much TV or computer work, exercise and stress at school or at home are quite common. Keeping a diary can be extremely useful in identifying these triggers, and can also help when consulting a doctor to demonstrate patterns in the attacks.

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Q: My daughter will be 7 tomorrow and started having migraine about 5 months ago. She has had her vision tested and a CAT-scan and everything is fine. I give her ibuprofen and 2 different suppositories but it only relieves it for a little bit and never goes away. She typically gets her migraine about 7 pm at night and then during the night, she tosses and turns and is whimpering all night and then about 5 am she wakes up and tells me she still has it and then vomits and lays down the rest of the day with a cold rag on her head. This goes on for 72 hours. There are times that she feels OK but that only lasts about 2 hours and then she is sick again. Is there any medication out there for children 7 and younger?

A: Many children require no medication to treat their migraine, often recovering well after a short sleep in a dark, quiet room. However with the length of time and the severity of the symptoms you describe, you may need to revisit your doctor for more medical advice on her treatment options.

Although medication prescribed for an adult with migraine should not be given to children, some doctors prescribe “off licence” at their own discretion. If attacks are severe and occur frequently, your doctor may feel she would benefit from taking a preventative medication. For these to be effective, they need to be taken at a regular time every day, usually for a period of several weeks or months, Pizotifen (sanomigran) can be very effective, the side effects of drowsiness and an increased appetite / weight gain are not usually troublesome for children, especially if the medication is taken at night.Alternatively, low doses of beta blockers (originally developed to treat high blood pressure) may be considered.

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Q: I am very worried about my 9-year old son. He told us that he keeps seeing a picture of a horse everywhere he looks. He has told us his parents and his teacher. Jake does not have a headache but in the past he sometimes mentions he had "deja vue" which I know may be connected to epilepsy. He has occasionally mentioned slight flashing lights. Could he be seeing this horse as a form of migraine?

A: It is possible that this horse could be part of a migraine aura, especially if this occurs in clearly defined short episodes. It is unlikely to be the case if he can see the horse most of the time. The aura is a neurological symptom and can often occur before the onset of the head pain in some sufferers, or without any ensuing head pain at all. Does Jake have any accompanying tummy ache or sickness?

You need really to take him to see your GP to confirm the diagnosis of migraine. It may be that the attacks can be avoided with some simple lifestyle changes. Things to consider are stress, dehydration, diet, sleep (too much or too little), exercise, TV / computer screens. It may help to keep a diary to see if there is a pattern.

What you describe as “flashing lights” is a classic description of an aura, however the diagnosis should be confirmed by a health professional.

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Q: My 6 year old daughter has just started complaining about terrible headaches.  This occurs mostly at school, she has missed allot of school because of this. these headaches have been getting more and more frequent. I do know she gets really sound sensitive. I have taken her to our physician and he said that she is too young to get migraines. And just kind of brushed it off as nothing. We have a numerous relatives, including myself and my 9 year old daughter, who suffer from migraines. I'm not quite sure what I should do she still gets the headaches. Should I look into a second opinion? 

A: Migraine can affect people of any age, even babies and young children. The symptoms you describe and the fact that migraine runs in your family indicate that this is likely to be your daughter's problem. It is important that the diagnosis is confirmed and appropriate treatment suggested. If your doctor continues to be unhelpful, ask to be referred to a migraine specialist. If you are in the UK, details of clinics are listed on our main website www.migraine.org.uk under About migraine, in the Support section. Children can be referred to specialists.

If you haven't already done so, talk with your daughter's teacher, or even the head teacher, about this just to make sure they are aware of the headaches and the time off school. Let them know you are also consulting a doctor and / or a specialist to try and bring the condition under control.

If your daughter does indeed have migraine, simple lifestyle changes can make a real difference. You can start to look at identifying potential triggers that may be causing the attacks, and try to avoid them. Triggers such as types of food and / or drinks, too little water, too much or too little sleep, too much TV or computer work, exercise and stress at school or at home are quite common. Keeping a diary can be extremely useful in identifying these triggers, and can also help when consulting a doctor to demonstrate patterns in the attacks.

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Q: My daughter has been suffering from recurrent bouts of stomach aches. She is currently under a paediatrician undergoing tests for food allergies, IBS, coeliac disease or abdominal migraine complex. She follows this pattern of getting flushed and going very quiet, then complaining of bad tummy ache, this is happening at similar times of the day and also frequently after a meal. She then goes very pale and has dark rings around her eyes and she may look like this for a while (even 24 hours). There have been since Christmas a couple of bouts of vomiting and she is normally quite a resilient little girl and rarely vomits at all.  I have been looking at your web site and was interested to see that Lara's symptoms do match your descriptions, obviously we would wait for a full diagnosis to really get to grips with this condition but in the mean time I was wondering if you could answer some questions. Is this a life long condition or will they grow out of it? I do suffer from migraines myself and so does my daughters grandfather, does this mean she may suffer as an adult too? Can it really be managed sufficiently with diet and avoiding triggers?  She is quite distressed about this and it has been h ard to calm her and stop her worrying she thinks she is sick and nobody else is and doesn't understand as she is only 5 years old.

A: Migraine is a very individual condition. Some people do "grow out" of it and others find it evolves throughout their lifetime. If your daughter is diagnosed with abdominal migraine it may be that she will grow out of it completely as she gets older or it may develop into a more recognisable headache pattern. Whatever type of migraine she may have, it is possible to manage it effectively so that it has minimal impact on your quality of life. There are some very effective treatments now. Often migraine runs in families. It may help to share this with your daughter so she understands that she is not the only one to suffer in the family, and explain that everyone is trying to help to make her feel better.

Migraine is not a true allergic reaction but a sensitivity which can take some time to develop after exposure to the trigger or triggers. It can be extremely helpful to look at diet and lifestyle habits to help manage the condition more effectively. It can help to identify and thus avoid her own personal triggers. The most common triggers include low blood sugar (i.e. do not go for more than 3 hours without food or 12 hours overnight, and always have breakfast), diet (food intolerances for example such as milk, eggs and wheat), drink (avoid too many sugary and caffeinated drinks, coca cola for example, and drink plenty of fresh water), too much or too little sleep, too much TV, stress (even at this young age, if something is causing a problem, this can be sufficient to trigger a migraine - it may be worth discussing this with your daughters teacher).

You are absolutely right to consult health professionals to confirm what may be causing the sickness.

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Q: My 12 year old daughter suffers from migraines, she only gets them about once a month or sometimes several months in between.  The only thing that we have been able to contribute to the cause is bright light usually florecent lighting ( like in the school gym).  I have found that Excedrin Migraine helps the best but my question is, Is caffenine good for a migraine or not?

A: It is good to hear you have found a treatment which works for your daughter, although Excedrin is not generally available in the UK. Caffeine is widely used in a number of migraine medications. It is believed that a small amount enables the body to absorb paracetamol more easily.  Paracetamol and aspirin are recognised as treatments for migraine, but these should not be combined with caffeine if your daughter wishes to sleep.

Painkillers containing caffeine have also been implicated in rebound headaches, which can lead to chronic daily headache.

Caffeine can be a trigger for migraine in some people so i t is best for your daughter to avoid taking it (e.g. in coffee or carbonated soft drinks such as coca cola, etc.), and drink plenty of water instead. As with all painkillers, it is imperative not to exceed the recommended dosage as this can lead to extra headaches (i.e. on more than 2 days per week).

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Q: My 13-year old son was told by our doctor a few years ago that the spots he would occasionally see were most likely tied in with a form of migraine - though he doesn't complain of headaches. However, in the past few months, he hasn't had (any) occurrences of these spots, but he has commented frequently on a kind of chill in his back that is gradually spreading. Could this be a new symptom of his migraine? Or, should we consider something else as the cause?

A: The spots in your son's vision sound very much like migraine aura. This aura does not have to be accompanied with a headache for it to be classified as migraine.

As the symptoms have changed now, you should consider a visit to your son's GP, which would suggest to any sufferers who experience a change in their symptoms or migraine frequency and/or severity.

Quite often migraine sufferers experience a cold sensation, although this tends to be more commonly at the body extremities: hands, feet, tip of the nose. Some sufferers use this symptom to recognise that an attack is on its way. However, as the coldness you describe for your son is different, both in location and duration, you should seek medical advice.

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Q: My son has been having headaches for the last 6 months but are beginning to get more frequent. They usually come on when he comes home from school and he says noise in school can bring one on. This weekend he was bad with his headache and was vomitting which was the first time that has happened. He is 6 years old. My doctor says that it could be migraine. I have had migraines since I was about 10 years old, and still suffer frequently with them. The doctor says that if his headaches continue and especially the vomiting that he may send him to have a scan. This worries me a lot. Can migraine occur in children as young as 6?

A: Although migraine is most often associated with adults, it can affect people of all ages, even young children unfortunately. In fact 66% of children aged 5-15 will have suffered from headache in the past year. For migraine in adults, the main symptom is usually an intense throbbing headache, usually on one side of the head, and as a sufferer yourself, I'm sure you know how debilitating it can be. In children, this symptom can be similar except the headache may be in the middle of the forehead or behind the eyes. This can be accompanied by an increased sensitivity to light and noise. Other symptoms include nausea and vomiting. Please try not to worry too much.

Your GP will know what is best for your son and, as with adults, there are plenty of ways to treat children's migraine: maintain a regular sleep pattern, drink plenty of water, eat a well balanced diet, and get regular exercise and plenty of fresh air. You may also wish to keep a diary to try to identify any trigger factors.

Click here for information about keeping a diary.

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Q: My daughter is 9 years old and suffers severe attacks of headache and vomiting which the doctor says is migraine but she also has a very strange taste in her mouth which she is only now telling me about. Is this also a symptom?

A: Your daughter is probably suffering from migraine with aura, formally known as classic migraine. The symptoms of th is type of migraine are the same as for migraine without aura, with the addition of neurological disturbances normally lasting 15 minutes to an hour before the headache starts. Many people think that migraine aura refers to visual disturbances (e.g. blind spots in the vision, zig zag patterns, flashing lights etc.) but migraine aura has many different forms and can affect all the senses so that they become heightened : sight (most common); touch (e.g. things may feel hotter or colder); smell (everything smells stronger, usually pleasant smells become unpleasant and/or sufferers may experience "phantom" smells which are not really there); hearing (sounds become amplified); movement (difficulty with co-ordination and articulation); and, taste (a strange taste in the mouth, food tastes different from normal).

Other aura symptoms include pins and needles, tingling or numbness in the face or limbs, feeling very cold, confusion and disorientation. Aura symptoms do sometimes continue into the headache phase of the attack. Your daughter may find that she has a strange taste in her mouth and that some food or drink tastes different to normal, sometimes unpleasantly different.

Another factor which may have an influence on taste is medication and this may explain why your daughter has some strange taste sensation during her headache phase. Some medication has been known to give a tin-like taste to some drinks, for example.

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Q: My son has been diagnosed with abdominal migraine. Is there any link to him eating certain food which can trigger it off? He is often absent from school because the pain is so severe, the medicine which has has been prescribed doesn't seem to help him, and he is in pain for a week at a time. I would like my son not to be ill every month and if it is connected to food then I could keep a food diary.

A: Food is just one of many triggers for migraine. It is a good idea to keep a diary to try to find out what is triggering your son's attacks.

It is very unusual for an attack to last as long as a week, so you might want to discuss the matter again with your GP and perhaps ask for a referral to a specialist. There is a list of headache clinics on our main website at www.migraine.org.uk.

As his current medicine is not helping, you could discuss other options with your GP as there are several different things that he could try. However if he has been prescribed preventative medication to take every day to try to stop his attacks, this could take several weeks to show full benefit.

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Q: Can migraine prevent you from taking part in activities, such as meetings and homework clubs? What do you do if you have an attack during a meeting?

A: Unfortunately migraine attacks can strike at any time without warning. However, there are some simple things you can do to try to avoid an attack, which should mean you are able to take part in activities and not miss out: have a snack and water with you as migraine can be triggered if you go too long without food or water; if you are indoors, have a window open to allow in some fresh air; if you are using a computer or a playstation (or similar) take a break every so often to rest your eyes.

If an attack does strike, it is important to take your medication as quickly as possible so make sure you have it close to hand. Ask your parents to tell the adults in charge of the club about your migraine – sometimes they can see the early signs of an attack and can help you to take your tablets sooner. Make sure also that they have your parents contact details so they can be called if you need to go home.

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Q: My son has recently been diagnosed as possibly having stomach migraine, he has been prescribed sanomigran which I realise needs time to work, his pain has gone from being off and on to almost constant now and with a ten week wait to see a specialist at the hospital I am becoming increasingly worried. He is twelve years old and this problem started a few months ago, please help. The pain is not intense at all times, but feeling sick and yet still feeling as if he wants to eat something and turning pale seem to be the common factors.

A: In around 4% of children, the predominant symptom for migraine is abdominal pain. As with migraine headaches, the abdominal pain occurs in defined episodes and can be associated with other symptoms such as vomiting, nausea, flushing or pallor, dislike of food, confusion, lack of co-ordination. Pizotifen (sanomigran), which is being given to your son, can be effective in preventing attacks but it doesn't work for everyone and side effects can include drowsiness, increased appetite and weight gain. Most preventative treatments can take up to 3 months to show full benefit. If it is successful, preventative treatment should be stopped after 6-12 months; some children find they never have another attack, but it can be started again if the attack frequency recurs. As your son's condition seems to be deteriorating, you may wish to consider going back to his GP to discuss alternative treatments. There are many other options to try whilst you are waiting for the appointment with the Specialist.

In the meantime, it may also be helpful to keep a diary. Keep an eye on what your son is doing on a daily basis, what he is doing at school, what he is eating / drinking, watch sleeping habits and make a note of each attack as it occurs (symptoms, length and time of attack). This will help monitor the attacks and what may be triggering them, which in turn will help your discussions with the specialist.

Click here for information about keeping a diary.

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Q: How can the pain in my tummy and the headaches my mum has both be migraine?

A: Everything that happens in your body is controlled by your brain. Migraine is caused by changes happening in your brain, which can make it send out messages to many different parts of the body. This is why migraine affects people in many different ways. Fortunately the changes in your brain don't last long and you are soon completely back to normal.

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Q: We are getting desperate with our 11 year old son.  He has been suffering from headaches for a year - much more severe headaches in the last 3 months and now he has headaches all the time from when he wakes up to when he goes to bed, painkillers do nothing. He has had his eyes tested very recently and wears very mild prescription glasses. We saw a consultant paediatrician who initially thought he had raised intracranial pressure and once he had the emergency MRI brain scan it was clear. They don't think it is raised pressure any more.
We are currently seeing a cranial osteopath  - my son has had 2 sessions (2 a week) with no improvement in his condition. The osteopath says it is musculo-skeletal and said she can make a difference in 2 weeks, we have 3 more sessions booked which will make it 2 weeks we have been going.  Our GP and the hospital doctor are both convinced it is migraine but I am not so sure.  The GP has prescribed Sandoz (Sanomigran Elizir - Pizotifen) which we have not started giving to our son as we felt that we should give the osteopath a chance to do what she could. We are thinking of acupuncture next and then trying the drugs.
Is this really migraine? He has a really bad headache all day but can eat, talk watch TV and just about manage school (but has recently been part-time) he has no problems at school or home - doesn't use a computer hardly at all, watches TV for maybe half an hour a day. He doesn't have chocolate, fizzy drinks sweets except as a treat maybe once a week. Help, some people have said food intolerances but again I am not convinced.
Any ideas? Can you have a permanent headache and it still be migraine?

A: Migraine is an episodic condition and sufferers are symptom-free between attacks so although there may be an element of migraine, your son's condition he may be experiencing other types of headache too. Daily headaches usually require a different treatment plan from straightforward migraine. It is rather unusual for a child to experience head pain from waking to when they go to bed on a daily basis and we can well understand your concerns. However, it is good news that your son has had all the necessary tests that have confirmed nothing more sinister is wrong with him, especially if both your GP and the hospital doctor are convinced this is migraine.

The pizotifen may work well for your son. It is a safe medicine which has been prescribed for many years. It is understandable that you want to see if the osteopath makes a difference first and then perhaps acupuncture, which is a good idea rather than treating your son in too many ways at once. But, if these do not appear to be of any benefit you could give the pizotifen a try. It is a preventative medication that he will need to take every day to try to reduce the frequency and severity of his headaches. He can take over the counter painkillers in addition for any breakthrough attacks – you may find that these are effective in conjunction with the Pizotifen. He may experience side effects such as drowsiness or increased appetite, but every individual reacts differently to new treatment so he may well not be affected at all. Any side effects can be minimised by taking the medication in the evening. It is important to allow enough time for the medication to work its way into his system so you will need to give at least 8-12 weeks before you know its true effectiveness.

It is good that you have identified and tried to avoid various factors that could be contributing to your son's headaches because sometimes children find it difficult themselves to relate their problems to anything they may have done. It might be the case that there is something occurring in his daily lifestyle that has not been recognised yet. It is a good idea to keep a daily diary, you could consider the following factors:

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