Eye Pain in Children: Is It Migraines or Something Else? - Neurology

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Eye pain


My son is 8 years old.
A few months ago, he started experiencing eye pain, specifically in his right eye, which eventually led to vomiting.
He has undergone a CT scan, and everything appears normal.
We consulted a neurologist, who indicated that it is a type of migraine.
I would like to ask if migraines can cause vomiting? Also, if the CT scan results are normal, can we be certain that there are no tumors? Is it possible for a tumor to be present but not detectable on the scan?

mich, 30~39 year old female. Ask Date: 2007/09/02

Dr. Zhuang Yumin reply Neurology


Dear Mich: Childhood migraines are becoming increasingly common, and vomiting is indeed a significant characteristic.
A normal CT scan can almost rule out tumors, except for very small lesions such as arteriovenous malformations, which may require an MRI for exclusion.
I suggest that you follow up with a neurologist for a while, and if there is no improvement, then further examinations may be necessary.

Reply Date: 2007/09/02

More Info


When it comes to understanding eye pain in children, particularly in the context of your son's symptoms, it's essential to consider a few key points regarding migraines and other potential causes.
Firstly, migraines can indeed cause significant discomfort, including eye pain, and they are often accompanied by other symptoms such as nausea and vomiting. In children, migraines may present differently than in adults, and they can sometimes be mistaken for other conditions. The fact that your son experiences pain primarily in one eye, along with episodes of vomiting, aligns with common migraine symptoms. Migraines can trigger nausea due to the intense pain and the body's response to it, which can lead to vomiting as a secondary symptom.

Regarding your concern about the CT scan results, it's important to understand that while a CT scan is a valuable diagnostic tool, it does have limitations. A normal CT scan typically rules out significant structural issues such as tumors, bleeding, or other acute conditions. However, there are certain conditions that may not be visible on a CT scan, especially if they are functional rather than structural. For example, some types of migraines or other neurological conditions may not show up on imaging tests. Therefore, while a normal scan is reassuring, it does not entirely eliminate the possibility of other underlying issues.

In children, recurrent headaches and associated symptoms like eye pain and vomiting can sometimes be attributed to other factors, such as stress, dehydration, or even eye strain from excessive screen time. It’s crucial to monitor your son's symptoms closely, including the frequency, duration, and intensity of the pain, as well as any accompanying symptoms. Keeping a headache diary can be beneficial in identifying potential triggers or patterns.

If your son continues to experience these symptoms, it may be worthwhile to seek a second opinion from a pediatric neurologist or a headache specialist. They can provide a more comprehensive evaluation and may suggest additional tests or treatments tailored to your son's specific situation. Treatment options for migraines in children can include lifestyle modifications, dietary changes, and, in some cases, preventive medications.

In summary, migraines can indeed cause eye pain and associated symptoms like vomiting, and while a normal CT scan is a positive sign, it does not completely rule out all potential issues. Close monitoring and further evaluation by a specialist may be necessary to ensure your son receives the appropriate care and management for his symptoms. Always consult with healthcare professionals regarding any ongoing concerns, as they can provide guidance based on the most current medical knowledge and practices.

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