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As noted above, migraine headaches are characterized by:

• Pain typically starting around the eyes, on the side of the head (temples), or in the forehead
• Pounding, throbbing, or pulsating pain
• Unilateral (one side of the head) pain but could be bilateral
• Pain duration of 2 hours to three days
• Sensitivity to light and sound during theigraine
• Disabling and incapacitating pain during severe headache
• Presence of an aura , a pattern of lines or shadows in front of the eyes, in a minority of patients
• Physical exertion, such as lifting or climbing stairs may intensify the pain
• Nausea, with or without vomiting in approximately 80% of migraineurs
• An almost universal desire to lay down in a dark, quiet room and sleep

Symptoms that are considered the most reliable in the identification and diagnosis of migraine headache include:

• Photophobia (light sensitivity)
• Phonophobia (sensitivity to sound)
• Exacerbation of pain with physical activity
• Nausea

The presence of nausea raises the probability of migraine headache to 90% and is considered to be the best predictor of a diagnosis of migraine headache.

Signs and symptoms in children may not be exactly the same as for adults. Although there is great variability in each child and even between attacks in an individual child, there are certain typical patterns for different age groups. For preschoolers, these include:

• Abdominal pain
• Bilateral head pain
• Vomiting
• Looking ill
• Strong need to sleep
• Irritability, crying, or rocking behavior

For elementary age children, typical presentation may include:

• Nausea with or without vomiting
• Sensitivity to light, sound, or smell
• Strong need to sleep
• Looking ill with circles under their eyes
• Thirst
• Tearing eyes
• Excessive sweating
• Diarrhea
• Swollen sinus

In addition to these symptoms, adolescents may experience headaches which are more similar to adults in that they tend to be:

• Unilateral
• Pain is more severe (throbbing or pulsating)
• Longer duration
• More regular intervals between migraines