How likely are children to inherit migraine? Recognizing some familiar migraine symptoms in her son, Ciara O’Rourke explores the genetic cause of migraine and ways to help children manage severe headache symptoms.

I've always worried that one or more of my boys might inherit migraine one day. Since migraine only affected the women in my family so far, I hoped they wouldn't have to deal with it.

However, my 10-year-old middle son has been having severe headaches over the last six months. At first, I thought these were due to other factors and hadn't considered pediatric migraine. But his last few attacks have been more frequent and painful in nature.

What causes migraine, and when does it start?

Migraines can start at any age, but the attacks often begin when you're a teenager and peak in your 30s. Migraine is very common, affecting about 17% of women and 6% of men.

People often ask me when my migraines started, and I usually say my early to mid-twenties. In all honesty, however, I'm not sure. I say "my twenties" because that's when they started seriously impacting my life, making me take days off work to recover. I may have had attacks back in my school or college days, but the negative impact wasn't at the same level.

I recently asked my parents if they recall me having migraines as a child. My father doesn't. My mother says she does, but I also had a lot of sinus and congestion problems when I was younger. I even had my adenoids removed for those problems, so any severe headaches were attributed to sinuses rather than migraine attacks.

It wasn't until my twenties that we recognized the migraine symptoms and began treatment.

Genetics, environment, both… or neither?

The causes of migraine and its development are varied. Recent studies estimate that about 42% of migraine cases are inherited, meaning there's a good chance of getting the condition from a parent or grandparent. But migraine is mainly seen as a complex condition that arises from a mix of genetic and environmental factors, such as:

• Genetics that make you more sensitive to certain foods, smells, or bright/flickering lights
• Your hormones
• Changes in nerve and blood vessels in the brain and your genes
• Other reasons not yet discovered

I never fully understood why I got migraines, but it made sense to learn they affect women more than men and that genetics play a role.

And, as I said before, migraine does run in the family. My mother had migraine attacks in her twenties, but the condition went away after her six pregnancies. I have three boys, and I also had fewer migraines during pregnancy. Unfortunately for me, they returned following each birth.

My son’s symptoms were showing several red flags for migraine

Generally, my son’s migraine attacks start in the evening and develop rapidly. He can't identify signs of an aura yet, so his first noticeable symptom is a sharp, severe headache. This is often accompanied by fatigue and irritability. On one occasion, he also developed nausea and had a vomiting episode.

After sleep and pain relief, my son's migraine symptoms are usually gone by the morning. I say usually – sometimes, the headache is still there in the morning, and he's unable to eat or get out of bed.

As you would expect, he gets very upset when this happens, as the head pain can be quite severe.

As his mother, it's so hard to see him suffering like that. As someone with chronic migraine, I know there's little anyone can do to help.

Seeking medical advice for my son's headaches

I kept checking my son's headaches and other symptoms. After a discussion with my husband, we agreed that the attacks were frequent and severe enough for me to consult with my neurologist.

I ended up talking to my nurse specialist, and she (as always) was very helpful. After I relayed my son's symptoms, she suggested that migraine was likely. She also said migraine in children is becoming more common - especially if one or both parents have a history of the condition.

Keeping a headache journal to navigate our next steps

The nurse specialist suggests I keep a headache journal for my son and told me what to include, such as:

• The time his attack started
• How long the attack lasted
• What occurred before the attack, such as what he ate, saw, did, or how he felt. This could help with finding his headache triggers and possibly prevent some migraine attacks in the future.
• What symptoms he experienced
• The medications I gave him

I use a headache diary as part of my own migraine management and find it useful.

During an attack, the nurse recommends that I place a cool, wet cloth on my son's forehead as he rests in a dark and quiet room. She also says to keep him hydrated with regular sips of water.