Update on ds's migraines/neurolgist appt.

[*********]

So Zee had an appointment with a neurologist last week. His pediatrician had diagnosed him with migraines, and refered us to the neurologist. He's also been getting daily headaches; the migraines are much less frequent, but they include vomiting, and he turns pale with dark circles under his eyes. It's kind of frightening, to be honest.

 

The dr. was great, very thorough. She prescribed cyproheptadine for him to take daily for his regular, daily headaches he had been getting. Apparently it is a antihistamine that's been around since the 50's, and it should eventually help him be headache free. We started it last night (we were on vacation since just after the appt, and didn't want to start a new med. while not at home), and we'll see how it goes. He's supposed to be on it until he's been 'regular headache' free for a month.

 

For his migraines, she prescribed Zomig or Maxalt, whichever our ins. will cover. We're still trying to get it approved by ins, since they want ds to try Imitrex first. Only problem is that dr and I would prefer that ds take the dissolving tablet form of Zomig or Maxalt, and Imitrex is only available in pill (which he can't swallow yet) or nasal spray. I used to use the nasal spray of Imitrex, and it tastes horrible (I use the pill form now).

 

Anyway, neither the ped. or the neuro. recommended a MRI or a CAT scan. When I told my parents about all of this, my mom really thought they should have done one or the other, since he's so young to be getting migraines. I tend to agree with her. But, I thought maybe it would be a good idea to keep a med/headache record for a month or two, then re-evaluate when we follow-up with the neuro.

 

Anyone have any experience with the daily cyproheptadine, or the Zomig/Maxalt? I hate giving my kids meds that I know very little about, but I have confidence in our ped. and the neuro.

 

I just want my little guy to be headache/migraine free. And there's still that mommy worry in the back of my head that maybe the migraines are being caused by something awful.

 

I hate it when my kids are sick. Isn't it harder to watch them suffer than to suffer ourselves? :crying:

[Karen in CO]

I used to take Maxalt for my migraines, but it often left me with a headache (kicked in the head feeling) after the migraine went away. Right now I'm taking Relpax which is terrific, but I wouldn't recommend it for a kid at all - it makes me feel very dizzy.

 

When you're keeping the Migraine diary, please also keep a food diary. My doctor suggested this ,and I was able to learn that mine are almost 100% food triggered and by very common ingredients like corn, wheat and cinnamon.

[Perry]

Anyway, neither the ped. or the neuro. recommended a MRI or a CAT scan. When I told my parents about all of this, my mom really thought they should have done one or the other, since he's so young to be getting migraines. I tend to agree with her. But, I thought maybe it would be a good idea to keep a med/headache record for a month or two, then re-evaluate when we follow-up with the neuro.

 

And there's still that mommy worry in the back of my head that maybe the migraines are being caused by something awful.

 

I try to avoid any kind of test unless it's absolutely necessary. The "awful" things almost always show up on a physical exam. Neurologists are really good at finding abnormalities on the physical. If he had a normal exam, it's awfully unlikely that he would have something bad show up on CT or MRI.

 

Read this about CT scans.

Edited June 29, 2010 by Perry

[michmom]

I know nothing about migraines in young children but with that caveat, I will say that I have had migraines for 35 years so I really feel sorry for your child. I did try Maxalt and it made me feel nauseous but I am sure different people have different reactions. I also take Relpax successfully and previously took Imitrex until it no longer worked for me but do not know about the use of these drugs for children. I also take Topamax every am and pm as a preventative medicine.

 

I would also encourage keeping a food diary. I don't have foods that trigger migraines but a lot of people do. What also has made the most difference for me is lifestyle. Regular exercise, sufficient sleep, plenty of water, and dark sunglasses in bright sun all make a difference. Also, not skipping or being late in eating meals. Three regular meals with morning and afternoon snacks. Healthy eating in general and I try my best to stay away from processed foods. These are all relatively simple things to do. I do not eat strange things and it does not take a lot of effort to make these changes part of my life but doing so has made a huge difference in the quality of my life as the number of migraines has decreased significantly. If I do not follow these guidelines there is a huge difference. I really figured most of this out by trial and error over the years and have managed to wean myself off of much larger doses of medicine.

 

HTH

 

Lynn

[mryann]

I don't have any advice re: medicines but I did want to recommend one more type of treatment. During the winter, my then 11 year old had daily headaches for several months. We ruled out vision problems, took him to the ped and made an appointment with the neurologists at the local children's hospital. Meanwhile, we began to take him to the chiropractor. It took several weeks of 3x/week adjustments, but the headaches completely disappeared. I don't know if this treatment would help your kiddo, but I wanted to suggest it. Daily headaches are miserable.

[Thea]

Two of my dc have been diagnosed with pediatric migraines. My ds' are optical and not accompanied by pain. He hasn't had one for almost 6 mos.

 

My dd has 'typical' migraines which are usually preceded by an aura. She was prescribed Maxalt and has had great success with it. We try to treat the migraine with ibuprofen and tylenol w/some caffeine and quiet first, but if that doesn't work within an hour, she takes a Maxalt.

[hoosiermom]

Michmom made some very good points! I, too, am a migraine sufferer and have been since I was a child. My own dd started having migraines around age 8. I have only identified one food trigger (shrimp) but my dd knows that if she od's on sugar, a migraine is the result. I can't emphasize enough the points made earlier--sufficient sleep, regular meals, proper hydration, exercise. For some, caffeine is a trigger. For me, caffeine will often reduce the severity of a migraine. But to maximize the benefits of caffeine, I avoid it unless I need it for a headache. Dd, now 14, does not want to use a Rx med. She treats her headaches alternately with Advil or Tylenol as she thinks one seems to lose its effect if used consistently. She also seems to need a nap to get rid of headache.

 

I have used Zomig for several years. I take a pill--didn't realize there was a dissolvable tablet. I found that I could actually take 1/4 of a pill and still see good results. It will sometimes take up to 2 hrs to relieve the headache no matter what dosage I take, and sometimes it just doesn't work. If I have to repeat the Zomig 3-4 times over the course of a couple of days, it can make me feel dizzy and kind of wiped out. I tried Maxalt a few times but it didn't seem to be as effective. I think it's a matter of trial and error to see what is most effective for each person.

 

Topamax apparently works wonders for some as a daily preventative. However, it made me lose a lot of weight (I was already very thin), and it affected my thinking process--I seemed mentally sluggish--couldn't always think of the word I needed, stumbled over words, etc. Not sure if it would be prescribed for a child.

 

Best of luck,

 

Cathy

[homeschoolally]

Cyproheptadine alone (besides avoiding triggers) has been enough for my ds, we never needed to fill the prescriptions for the 'migraine' meds.

 

Check the side effect profile on those carefully--for us, we decided that letting the occasional (they reduced by 90% with cyproheptadine only) migraine run its course was better than worrying about side effect risks.

 

Congratulations to you both!! I hope it helps your son as much as it has mine! =) Cyproheptadine has been an answer to prayer! Feel free to PM me if you have any specific questions.

 

ETA: We did a CT scan and it was pretty tough on my son. They wanted to do his abdominal area as well because his nausea was so bad (turned out to be just migraine nausea) so they had to do the contrast dye with an IV. It was a pretty bad experience for him, and I regret doing it--within a few days of the cyproheptadine, the symptoms went away. It would have saved him from having the CT had the dr. thought to investigate migraine meds first. Obviously, it is important to do it if you can't find a cause for the headaches--but I didn't realize how traumatic it would be for him and wish we'd ruled out other ideas first.

Edited June 29, 2010 by homeschoolally

[Veritaserum]

My dd (8) had an MRI to rule out scary stuff (brain tumor, etc.) before being diagnosed with migraines. What has helped get her daily mild/moderate headaches under control is to change her diet. Heal Your Headache by Dr. David Buchholz (a neurologist) has been life-changing for us. Another thing that helps is to make sure she eats every 2 hours. A drop in blood sugar is an instant trigger for her to get a headache, which can then develop into a really horrible migraine.

 

Her appointment with the ped. neurologist is in August (there's only one practice in the entire state and it takes forever to get a new patient appointment). I'm going to request a prescription for a med that she can take when she gets a migraine, but the diet/eating frequently is thankfully preventing the daily headaches.

[Granny_Weatherwax]

No advice. Just wanted you to know I am praying for your DS.

 

:grouphug:

[vettechmomof2]

My brother and I have gotten migraines since we were 3 years old. So it really can happen at any age unfortunately.

I take maxalt for my migraines and it works well just knockes me out, which is what I need for a migraine anyway. I need to vomit and pass out.

I hope he feels some relief soon!

[dsmith]

I have Maxalt, but I never ended up taking it. After a few years on Relpax, I decided to stop taking the meds. It was getting to the point where my migraines were more frequent and more severe. Since I stopped the meds I barely get migraines, but I do have the meds in case I need it. I think a headache diary is very important to pinpoint triggers. Some bad triggers for me are air fresheners, carpet and fabric fresheners (Febreze and Carpet Fresh are permanently banned!!!), and some scented candles. Some cheeses will trigger a mild migraine, but I love cheese!:001_smile: Just keep in mind that it is not always food - many chemicals we use in the house can be triggers, so make note of cleaning products used, etc. Exercise or a blood pressure spike caused by anger or stress can trigger a migraine in some people also. A day in the sun will give me a migraine unless I wear sunglasses. Medicine to treat the actual migraine is great, but some of these meds have some nasty side effects. I remember taking a Relpax with some other med and having such horrible pressure in my chest I thought I was dying! Now I keep my focus on prevention. I haven't had to take a pill in a few years. Sorry your ds is going through this at a young age - I didn't start until my twenties.:grouphug:

[SailorMom]

I was around 11 when I started having mine. I LOVE Relpax - but I don't know if it's ok for kids.

Maxalt was ok - but not as good as Imitrex....

 

As for prevention - I would really look in to food allergies - I know MSG triggered mine frequently.

 

As for the MRI/CT.... there is a very basic neuro exam a neurologist will do - and anything beyond migraines will usually show up right away. If you are concerned still, though - just be watchful. If he gets clumsy, or develops a twitch... anything out of the norm - go back to the neuro.

 

Also - the migraine meds are pretty strong stuff. Imitrex caused me to have PACs (abnormal heart rythms) and occasional chest pain. If you can keep the usage of the "rescue" drug to a minimum - he'll be better off.