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Last updated: 23 June 2024 Print

Migraine in childhood

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Acute Treatment of Migraine in Pediatrics: Guidelines and Recommendations

Guidelines Overview

  • Published By: American Headache Society and American Academy of Neurology (Oskui M et al., 2019A; 2019B)
  • Year: 2019
  • Focus Areas:
    • Prompt treatment
    • Migraine characteristics and associated symptoms
    • Medication formulation
    • Incorporation of healthy lifestyle habits

    Importance of Acute Treatment

    • Risks of Ineffective Treatment:
      • Medication overuse headache
      • Progression to chronic migraine

      Medication and Treatment Options

      • Correct headache diagnosis
      • Diagnostic testing for secondary headache disorders
      • Assessment of premonitory/aura symptoms, headache features, associated symptoms, and overall disability
      • Goal: Quick-acting, effective therapy with minimal side effects

      Counseling and Early Intervention

      • Triptans:
        • Most effective for pain relief
        • Less effect on associated nausea and vomiting

        Considerations for Triptan Selection

        • Limited clinical trials for migraine-associated nausea
        • Demonstrated safety in pediatric gastroenteritis
        • Recommended for significant nausea or vomiting

        Patient and Family Education

        • Over-the-Counter Medications:
          • Acetaminophen, ibuprofen, naproxen
          • Weight-based doses

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