Migraine

Hi guys,

My friend is taking her daughter to a neurologist this week to see about her constant headaches. The kids she has are on medicaid, so many specialists won't take their case.

My friend's daughter is 9, she has already been diagnosed with depression, ADHD, and ODD (oppositional defiant disorder). Depression runs in her family.

I would go with her to the specialist's but I have my own appointment to go to. My mom is going to go with her instead, but I had a difficult time conveying to my mother the things that this mother needs to be asking her daughter or doing. My mom's excuse is that she is 9 and can't adequately express herself, but at 9 she should be able to communicate vision problems, nausea, sleepiness--things like that. Sometimes her headaches are so severe they pull her out of school.

I would like to put together some sort of suggestions for them to take to the appointment. I don't know how they will begin to treat the girl but it makes me nervous that they may miss the mark, and with the family in the socioeconomic position they are in this may be a long and messy road. I hope that it isn't the case.

So, my questions are, for a 9 year old, what are appropriate preventatives? She's on medications for her mental disorders; I may need to find out what those are?

Can she take triptans and if so which ones, or does it matter?

Topamax--with a child so young would it be better to start off with something different than this?

Would they even give a CAT or MRI to a 9 year old to check for other problems? I'm going to guess they would; I just want to make sure.

The last time I took my mom to a migraine appt with me she was all over my doctor about this girl's problems, and asking about pediatrics and PFOs. I keep trying to tell her they won't treat a PFO in a kid that young without other problems but I'm afraid she's going to push the agenda with this doctor too. I understand her need to have things fixed for people but I can't get her to understand migraine in the first place. She tries; she's sympathetic and supportive, but she's missing some points.

Any other suggestion would be aprpeciated! Thanks.

You've probably seen this article before, but it might be worth reviewing, at least to give you some ideas to pass along to your mom: Migraineur's Guide to a Successful Doctor's Appointment. It's geared more toward adults, but it's a good start.

Other than that, I would suggest having your mom review, and show to your friend, some migraine basics if they haven't already looked at them.

That's so sad that your friend and her daughter in this situation. Migraines and related illnesses are tough enough for adults, let alone kids, especially those in a difficult socioeconomic status.

Hopefully you'll get some good suggestions from some of our other members.

Hi there,

At 9 you would think kids would be able to tell you exactly what is going on and when. But they really aren't able to articulate that very well yet. My son, 13, is now able to describe how he is feeling much better, and he doesn't have any other issues, except a teenager with Migraines.

I would not have my child on topamax, period. There are other options out there. In fact, some medications for ADHD are used to treat Migraine disease as well, like Adderall, Strattera and Concerta. These are on the preventive list. Click HERE

I hope that helps a bit.

My daughter saw my migraine specialist when she was 10. He wanted to give her a triptan but I nixed that. He gave her Midrin. I wouldn't put a 9 y/o on a triptan; I'm not sure they're even approved for kids that young.

Her other conditions may make this a difficult visit.


I would think it would be ok for her to have a ct scan or mri.

Hi Leeloo,

I know you were looking for migraine-related info, but I just had to respond anyway! These are a few non-migraine concerns that came to mind when I read your post...

I spent many years working with children with mental health difficulties. I did both family and individual therapy with kids with diagnoses from autism to depression and everywhere in between.

I always get concerned when I read about a child who is diagnosed with both depression and ODD. In kids, depression often manifests itself as anger and defiance. As Nancy said, children aren't always good at expressing themselves at age 9. When depression becomes deep, kids often act out in what appears to be anger. If the person doing the child's assessment is not VERY experienced with diagnosing depressed and ODD kids, a child who is ONLY depressed can sometimes end up being called ODD unnecessarily. I sure hope your friend has a good child psychologist working with her daughter...

Obviously I've never met this child, so these are just my thoughts (for what they're worth!)!

jenny

Hi Leeloo

I'm sorry to hear about your friend's daughter. It certainly is difficult with children to try to figure out what is going on.

My son started with migraines at age 5. We did have a CT scan right away. The dr. didn't feel it was necessary, but agreed to do it for my piece of mind. Luckily, it came back normal. It seems like a good starting place.

When my son started preventatives, he started on periactin an antihistamine at age 10. It was a great drug for him for about 3 years. I think that is a common starting point. Elavil was his second preventative.

I do have a book that I used often when my son was younger. It's called "Headache and Your Child". It's written by Seymour Diamond MD. Preventatives it lists are Periactin, Elavil, Inderal, Verapamil and Depakote. Basically, those are examples from each drug class. It also mentions that the anticonvolusents are not recommended for very young children. I don't know what "very young" is definded as.
Triptans are mentioned in the book as well, but again no particular age is mentioned.

If you can help your friend come up with specific questions for her daughter about her migraines that would be helpful. I still use this method on my 14 year old. I ask him where the pain is located. When did it start. What number is it? I also keep a migraine diary. How often is she having migraines? What does the pain feel like? Is it pounding or stabbing or aching etc...? Does she take any meds when it happens? Do they help? Does anything help? Is she nauseous or vomiting? Does she have an aura?

It's just like when you ask kids "how was school?" They always say fine or OK. When you ask specific questions you can get a lot more information.

I've also read in various places that the alternative therapies (biofeedback, acupuncture etc...) can be very effective in children. None of them were effective for my son, but you never know what might work for someone. I wonder if medicaid would pay for any of those?

I hope that helps. I think you're a great friend for trying to help her. I hope your friend has a good visit and please keep us updated.

Jean Ann

Jenny, thanks for your input.

I don't have many answers; I don't visit this friend much anymore because she is a smoker and I tend to keep myself out of the majority of places were smoke is overwhelming because it makes me ill, plus the asthma problem...Which is unfortunate because we have always been great friends. All of the information I get is from my mom who visits her every week.

My friend has been on antipsychotic medications herself, particularly a stint with lithium. Mental illness, including schizophrenia, runs in the family. When they diagnosed her daughter with ADHD and ODD plus depression, I was a little worried myself...That's a lot to have on one's plate so young and I think you are right. But I do not know who is seeing the girl for her issues. I should ask. Thank you for pointing that out. Part of the problem is a control issue in the household. Her mother tries to parent in a manner I think many would feel is efficient, but they live with (the mother's) her parents and her parents are always overruling her decisions. So the girl is a little more than confused.

Thank you for your input.

quote:

Originally posted by jennyc:
I always get concerned when I read about a child who is diagnosed with both depression and ODD. In kids, depression often manifests itself as anger and defiance. As Nancy said, children aren't always good at expressing themselves at age 9. When depression becomes deep, kids often act out in what appears to be anger. If the person doing the child's assessment is not VERY experienced with diagnosing depressed and ODD kids, a child who is ONLY depressed can sometimes end up being called ODD unnecessarily. I sure hope your friend has a good child psychologist working with her daughter...

Obviously I've never met this child, so these are just my thoughts (for what they're worth!)!

jenny

Thanks Nancy and Jean Ann, I will try to get a report soon and find out what the neurologist said! I will also have to see if I can find that book for her too, if she is indeed having migraines.

Thanks for your help gals!