?Migraine? 10 year old

Posted By Pat Szuba on December 06, 1998 at 08:48:51:







My 10 year old son recently has had 2 episodes of unilateral headaches,
accompanied by scalp tenderness, nausea and sometimes vomiting.
Some general history: He was diagnosed with asthma at age 7.  He has known
allergies to mold(highly), dust, animals, grass and tree pollen.  Last year
he had a bronchoscopy (at Johns Hopkins-ped pulmonary) due to a
uncontrollable cough, which found his lungs
had been bleeding. As explained to me they found macrophages(spelling??)
that feed on hemo-
ciderin.  But after additional testing, did not find any specific cause
and chalked it up to either viral or allergic response.
He has also complained of unexplained abdominal pain that would last 2-3
days.  He's has about 5 episodes of this per year for the last three years.
He had an upper endo(also at Hopkins) which was relatively normal,
although he does show physical signs of reflux and minor reflux was
demonstrated on an upper GI.
He now takes Prilosec for reflux (which did seem to help), Beclovent
inhaler-2 puffs 2x's a day, Vancenase pockethaler-2 puffs in each nostril
2x's a day, and Claritan.  Even though it sounds contradictory, he appears
healthy as a horse, is very athletic. Just puffs on his Proventil inhaler
before every sporting event. He is a good student and likes school(was
sent to a psychologist to determine if this was school related--answer
was no--and I strongly concur)
Now, to the headaches
The first episode, approx one month ago, lasted for 3days and just went
away as fast as it came.  No relief
was gotten from Tylenol or ibuprophen.  It was blamed on his increased
steroid dosage(inhaled Beclovent).  He had an asthma attack a couple days
before that.  
The second just days ago, came thundering upon him in the middle of the
night and woke him out of sleep.  Right sided pain around the temporal-
parietal region.  By the 2nd day, his pediatrician put him on Midrin, but
after 6 doses, it didn't seem to help and on the third day we tried Imitrix
nasal spray.  Still complained of the headache and nausea, but the scalp
tenderness diminished.  He still has a headache and nausea today.
By the way,he had a BIG chocolate candy bar before he went to bed that
first night.
Upon physical exam, he was also tender in his RUQ and he's having a GB
sono today.
My pediatrician is wondering if there is a link between the abdominal
pain episodes and the now ?migraine headaches.  She says that migraines
in children often appear that way.
Do you think the Prilosec may be a cause?  He's been on that for 6 months.
We have taken him off of it for now.  He's also been tested for common
food allergies and that was negative.  He does seem to have an intolerance
to liquid milk, but not milk products in moderate doses.
What can I do for prevention, without getting over medicated.  He takes
so many things already.  I read about feverfew, but understand you don't
recommend it.
With all I've thrown at you, can you link any of this together?