Which characteristic differentiates migraines from tension headaches in children?

Migraines in children are often characterized by the presence of an aura, which may manifest as visual disturbances, sensory changes, or even speaking difficulties prior to the onset of the headache itself. This aura can influence the nature and severity of the headache episode, making migraines distinctly different from tension headaches, which do not typically include an aura.

While tension headaches may occur intermittently, that characteristic is not exclusive to migraines. Additionally, tension headaches are generally not associated with the severe and pulsating pain commonly found in migraines. Children experiencing tension headaches do not usually report an increase in symptoms with rest. In contrast, the presence of an aura before a migraine is a key distinguishing factor that helps healthcare providers identify and treat different types of headaches in pediatric patients.