AKTUÁLIS-E?

ÓVODAI TÉMA-E?
INTERAKTÍV-E?
Kinek van tapasztalata (óvodai) migrénről vagy akár csak fejfájásról? Hiszen általában, akik
még nem tapasztalták, egy kaptafa alá szokták venni.
Amennyiben nem tapasztaltak ilyet, esetleg saját vagy családon belül előfordul-e? A fő
tüneteket közösen összeszedjük.
Most, hogy megtudtuk főbb tüneteit, mit gondoltok, hogy kezelhetjük ezt a csoporton belül?
A pszichogén fejfájásoknak két nagy csoportja van: 1. tenzióval járó fejfájások, 2. migrénes jellegű
fejfájások. Tenzióval járó fejfájások Ez a típusú fejfájás általában kétoldali, diffúz, tompa és kitartó
fájdalom formájában jelentkezik. Ezt olyan általános tünetek kísérik mint: gyengeség, rosszullét,
fáradtság, sápadt arc stb. A fejfájásos roham alatt gyakran tapasztalhatók a nyak és a vállizmok
görcsös összehúzódásai. A két fejfájástípus közül inkább ennél a formánál valószínűsíthető az
intellektuális gátlás szerepe a betegség patogenezisében. Súlyossági fokuk széles skálán mozog, ezért
terápiájuk is nagyon eltérő lehet. Enyhébb formáknál sokat segíthet a masszázs, a simogatás, aktív
mozgatás, odafigyelő magatartás és együttérzés. Súlyosabb formáknál a relaxációs gyakorlatok (pl.
autogén tréning) és az adekvát pszichoterápia segíthet. Migrénes jellegű fejfájás Ennél a formánál a
kiváltó okok között az örökletes tényezők is fontos szerepet játszanak. Nagyon gyakran fordul elő
azoknál a gyermekeknél, ahol egyik vagy mindkét szülő migrénre hajlamos. Tünetei lényegesen
eltérnek a tenzióval járó fejfájástól: általában kétoldali, heves, lüktető fájás, amelyet hányinger és
néha hasi fájdalmak kísérnek. A rosszullét alatt rendszerint előfordul a hányás, amely
megkönnyebbülést eredményezhet, és ekkor a gyermek elalszik. Gyakran fejfájásmentesen, frissen
ébred (Kelenné 1982). Bár ez a típusú fejfájás általában jó képességű gyermekeknél a leggyakoribb,
mégsem zárható ki az intellektuális gátlás szerepe a betegség kialakulásában. Ezt talán az igazolja
leginkább, hogy a vakációk időszakában ezek a gyermekek gyakorlatilag tünetmentesek. Terápiájuk
csak annyiban tér el az előző típusnál felsoroltaktól, hogy gyógyszeres kezeléssel egészítik ki (főleg
azoknál, akiknél gyakrabban jelentkeznek a rohamok).

Susan Honeyman könyvében próbálta a tévhiteket eloszlatni, miszerint a gyerekek kevésbé

érzékenyek a fájdalomra, hogy a gyermekgyógyászati fájdalmat diagnosztizálni kockázatos,
illetve hogy a gyerekeknek ez esetben csendben vagy legalábbis nyugodtnak kell maradniuk,
melyhez sokszor az azonnal befecskendezett orvosság is hozzájárul. Sajnos sokan a
migrénesekre úgy tekintenek, mint akik csak sajnáltatják magukat és csak panaszkodnak 
ezért azt hiszik, hogy nincs szükségük kezelésre, gondolják, gyerek még, majd kinövi. Holott
ez roppant helytelen gondolkodás, hiszen ennek a későbbiekben szövődményei is lehetnek.
Many pediatricians and parents view migraines as an adult condition. And because many
children complain of headaches more often during the school year than the summer, parents
often think a child is exaggerating symptoms to get out of schoolwork.
Often the real issue, say doctors, is that changes in a child’s sleep schedule, including getting
up early for school and staying up late to study, as well as skipping breakfast, not drinking
enough water and weather changes can all trigger migraines when the school year starts.
“In many areas people just don’t think kids can get migraines,” says Dr. Andrew Hershey,
professor of pediatrics and neurology and director of the headache center at Cincinnati
Children’s Hospital Medical Center. “But kids shouldn’t be missing activities and having
trouble at school because they’re having headaches. If it happens, it shouldn’t be ignored.”
It’s estimated that about 10 percent of young children and up to 28 percent of older teenagers
suffer from migraines. (Hormonal changes during puberty can also be a trigger.)
But childhood migraine often doesn’t show up the same way as an adult migraine. While
adult migraines often last four hours or more, in a child, the duration of a migraine can range
from as little as one hour up to 72 hours. In adults, migraines typically settle on one side of
the head, but in children migraine pain is often felt across the front of the forehead or on
both temples rather than on just one side. As a result, childhood migraines are often
dismissed as sinus headaches.
Parents often have a hard time distinguishing between real pain and the imaginary maladies
that young children sometimes invent. Dr. Hershey tells the story of a 6-year-old boy with
daily headaches, whose parents thought he was just trying to avoid school. His parents finally
sought treatment and by the time he was in the third grade the headaches were under
control. “He was a different kid, more active and happy all the time,” said Dr. Hershey. “The
parents realized he really had been having headaches, but they had been denying it.”
Second, he says, children who have more than one headache a week may need preventive
therapy, like low doses of antidepressants or anti-seizure drugs that have been shown to
prevent adult migraines. And lifestyle changes like exercise, drinking more water, getting
adequate sleep and not missing meals are essential.

komment: I do hope that this article helps to shine a spotlight on migraines in

children. I was (luckily) diagnosed at the age of 3 and I remember the experience
well. A trip to the ER, suppository for the nausea. The ER doctor actually diagnosed it
on the spot and referred me to a specialist. I began to learn early on what triggered
them and how to best manage and treat them. My parents were constantly educating
my teachers and school administrators on migraines. They made sure that my
complaints at school were taken seriously and arranged for me to make up work that
I missed without penalty. With that cooperation, I was still able to excel in school
despite missing over 30 days per year for all of my academic life.
The attention and seriousness given by the adults in my life helped me to develop the
skills to recognize early-onset symptoms, identify specific triggers (and avoid them),
and manage stress. The latter is a skill that has greatly benefitted me in life. I am 32
now. I still suffer from migraines, but those management techniques allow me to
remain productive and active.
As a very young child, I had to first learn how to explain my symptoms. There aren’t
that many words for “It hurts.” in a childs’ vocabulary. Parents and medical
professionals should be attuned to that fact in order to identify if a child is really
suffering from a migraine.

I just want to add that I hope that in the last few years, school nurses have become more enlightened
about migraines. Back then, when my son crawled into the nurse’s office, holding the walls and asked
for help, all she said to him was, “Do you have a pass?”

The sooner a migraine sufferer and the parents are educated and get the tools to manage it the
happier everyone will be.

So my little guy soldiered on through his first three-and-a-half years of elementary school, suffering
from about two migraines a month, missing a lot of school, and getting picked up from the nurse’s
office halfway through the day quite often. Until we received a firm diagnosis of “pediatric migraine”
from a physician, only rarely did one of his teachers truly seem to believe that the poor kid was telling
the truth.

I found that the best approach to treatment was to address the headache at the very
first sign. She was taught to let me or any other adult caring for her (like a teacher)
know immediately if her head started to hurt. When she was given medication right
away it reduced the length and severity of the headache significantly. And sleep was
usually a really effective solution, too.
Unfortunately, her kindergarten teacher didn’t believe her initially! I needed to really
educate her about the subject of childhood migraine. Many teachers have never
heard of young children getting headaches and believe they are lying when they
report them.
We also found that it was extremely important for her to not miss meals or sleep.
Regularity in her schedule was very important and when she did miss a meal or not
get enough sleep it would often trigger a migraine.
MSG can be a trigger. I started to notice that my son would get migraines very predictably after
certain foods, many of which I didn’t know had MSG until I read the label (e.g. Doritos, certain snack
foods and flavored foods like chicken soup and spice mixes, certain school lunch items, and often
Chinese food). Now that we know to avoid MSG he gets much fewer migraines. MSG has many
different names (e.g. hydrolyzed yeast, vegetable protein, etc.) so as a parent I have to be very
careful. My son can now sometimes *taste* MSG and knows to avoid certain foods, even if we don’t
have a label to check. My poor son endured so much suffering because of an unnecessary flavor
enhancer that in my opinion should be banned.

Sokan írtak öröklődésről is már nagyszülőktől kezdve. Míg a szülő általában felnőtt korában lett
migrénes, utódja már koragyermek korában is, így az idő múltával egyre hamarabb jelennek meg az
eddig csak „felnőtt” betegségnek tartott jelenségek.