DOI 10.1212/WNL.0b013e3182745a97 2012;79;e168Neurology

Daniel KantorThe impact of migraine on school performance

 April 4, 2013This information is current as of

 

  http://www.neurology.org/content/79/18/e168.full.html

located on the World Wide Web at: The online version of this article, along with updated information and services, is

 

Neurology. All rights reserved. Print ISSN: 0028-3878. Online ISSN: 1526-632X.since 1951, it is now a weekly with 48 issues per year. Copyright © 2012 American Academy of

® is the official journal of the American Academy of Neurology. Published continuouslyNeurology

The impact of migraine on schoolperformance

Daniel Kantor, MD WHAT QUESTION DID THE RESEARCHERS INTHIS STUDY ASK? The researchers in this studytackle an often overlooked problem: how migraineheadache affects the school performance of children.1 Itis bad enough to have migraines as an adult (it maymean missing work, family functions, or social time),but migraines, which often begin in childhood, canhave a negative impact on the developing brain duringschool years. Many studies have shown that doing wellin middle and elementary school results in better highschool and college performance. Higher educationopens up opportunities for a better income and finan-cial quality of life. If migraines make schoolwork harderand lead to worse grades, this can affect future opportu-nities and brain development. The researchers set out todescribe the scope of this problem.

WHAT IS A MIGRAINE? WHAT MAKES IT DIF-FERENT FROM OTHER HEADACHES? Mi-graines are a type of primary headache disorder,meaning that they are not generally thought to becaused by something else, like a growth in the brain.Migraines cause headaches that are usually on one sideof the head. Sometimes the side may change or the painmay be on both sides at the same time. They are usuallymoderate to severe in intensity, last for longer than 4hours if not treated, get worse with activity, and throbor pulsate (although more rarely they have a dull ormore stabbing feeling). Aside from the actual head pain,migraine are often accompanied by nausea or difficultywith light and loud noises.

Some people have warning signs (often sparkling lightsor other visual symptoms) for migraines, called “auras.”These are called “classic migraines.” More often there is noaura, and these are called “common migraines.”

WHAT DID THE STUDY SHOW? The authorswanted to find out more about how migraines affectschool performance, so they approached two importantsources of information: teachers and parents. The au-thors asked the parents about any history of headachesand they asked the teachers about the child’s school per-formance. The authors found that about a quarter ofchildren had headaches with features of migraines andthat there were even children who had headaches onmost days of the month (this is called chronic mi-graine). There was a connection between coming from

a poorer home and the chances of having migraines.Children with migraine missed more days of school dueto the headaches than children with other types of head-ache disorders (not migraines).

There were a number of factors that led to poorschool performance:

• Having migraines at all vs not having migraines• More frequent migraines• Longer migraines• More intense/severe migraines• Having associated nausea with the migraines• Coming from a poorer home

Some factors did not affect school performance:

• Age (all the children were 5–12 years of age)• Sex• Race

WHERE AND HOW WAS THIS STUDY SET UP?Instead of looking at a single city or school, the authorsstudied children across different regions in Brazil.

I’M FROM THE UNITED STATES; WHAT DOESTHIS STUDY HAVE TO DO WITH ME AND MYCHILDREN? Studies of populations in different partsof the world help us to understand more about whatgoes on with our youth and in our schools. A similarstudy in your hometown may likely show similar re-sults. Of course the results may be a little different interms of percentages, but children have developing hu-man brains regardless of their address; remember, hu-man beings are more similar than we are different.

WHAT’S THE TAKE AWAY MESSAGE FROMTHIS STUDY? Migraines during childhood can havea negative effect on school performance. If your childhas headaches, it is important to get a clear diagnosis.Primary care providers often diagnose and manageheadaches. Neurologists are experts who often have spe-cialized training in the diagnosis and treatment of mi-graines. If your child is diagnosed with migraines, yourdoctor can recommend ways for your child to avoid orprevent headaches and also provide effective treatmentsfor the headaches that do occur. Although this study didnot look at this specifically, there is reason to believethat actively treating the migraines may help your childto do better in school.

PATIENT PAGE

Section EditorsDavid C. Spencer, MDSteven Karceski, MD

e168 © 2012 American Academy of Neurology

About migraine

Previously published: Klein E, Spencer D. About mi-graine. Neurology 2009;73:e42–e43.

WHAT IS MIGRAINE? A migraine headache is usu-ally a severe, throbbing headache that is typically onone side of the head and may last for hours. It is 3times more common in women than men.2 Oftenmigraine headaches are accompanied by nausea andsometimes vomiting. Generally, when someone is ex-periencing a migraine, he or she will feel the need tolie down in a dark, quiet place until the headacheends. The cause of migraine is not well understood,but it is believed that abnormal brain or nerve activ-ity causes blood vessels in the brain to both dilate andconstrict, leading to the headache. Some migrainesbegin with what is called an aura. Auras usually con-sist of strange visions of light or color. Occasionallyan aura may also involve a familiar smell or taste orweakness or numbness on one side of the body. Afterthe aura, the migraine headache begins.

HOW COMMON IS MIGRAINE? An estimated 28million Americans experience migraines. Specifically,that is 17% of American women and 6% of Ameri-can men.3 Headache is the most common reasonwhy patients see a neurologist, and migraine is themost common type of headache that neurologists see.

WHAT CAUSES A MIGRAINE? The cause of mi-graine is not well understood, but it is believed thatblood vessels in the brain both dilate and constrict,leading to the headache. During an aura, brain cellsbecome overexcited, and this increase in brain activ-ity leads to blood vessel changes, which cause theheadache. Sometimes the migraine disorder is hered-

itary, passed down through families. Often triggerssuch as stress, temperature changes, hormonalchanges, or changes in diet cause a migraine to start.

WHAT ARE THE TREATMENTS FOR MIGRAINE?Many different medication treatments are availablefor migraines. Some work to stop migraines afterthey start. Others are taken every day to prevent fu-ture migraines. Migraine treatments have varyingside effects. Depending on a patient’s migraine fre-quency and severity and other medical conditions,doctors may recommend different migraine medica-tions. Certain types of mental health counselingaimed at reducing stress levels to control headachesmay also help reduce migraines.

FOR MORE INFORMATIONAAN Patients and Caregivers sitehttp://patients.aan.com/go/homeMigraine Research Foundationhttp://www.migraineresearchfoundation.orgAmerican Headache Society Committee for Headache Educa-tion (ACHE)http://www.achenet.orgNational Headache Foundationhttp://www.headaches.org

REFERENCES1. Arruda MA, Bigal ME. Migraine and migraine subtypes in

preadolescent children: association with school perfor-mance. Neurology 2012;79:1881–1888.

2. Stewart WF, Lipton RB, Celentano DD, Reed ML. Preva-lence of migraine headache in the United States. JAMA1992;267:64–69.

3. Lipton RB, Scher AI, Kolodner K, Liberman J, Steiner TJ,Stewart WF. Migraine in the United States: epidemiologyand patterns of health care use. Neurology 2002;58:885–894.

PATIENT PAGE

Section EditorsDavid C. Spencer, MDSteven Karceski, MD

© 2012 American Academy of Neurology e169

DOI 10.1212/WNL.0b013e3182745a97 2012;79;e168Neurology

Daniel KantorThe impact of migraine on school performance

 April 4, 2013This information is current as of

 

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