Migraine Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 9, 2020

What are migraines?

A migraine is the most common type of primary headache in children. This means that the headache happens on its own and not as a result of some other cause like trauma or infection. Migraines tend to run in families and can be mild or severe. Migraines can stop a child in their tracks making them unable to go to school or play. They usually last 1 to 2 hours.

A migraine headache tends to be throbbing, can be located in one specific spot, and gets worse with running around. Sometimes, symptoms can occur before the headache starts that let your child know the headache is coming. This is called ‘aura.’ Aura most commonly occurs in the form of vision changes.

In addition to a headache other possible associated symptoms include:

  • Nausea 
  • Vomiting
  • Eye tearing and redness
  • Nose running and congestion
  • Droopy eyelids 
  • Sweating
  • Noise and light sensitivity

After the headache goes away, usually children will feel tired or drained and wish to sleep.

How to Treat a Migraine

Treatment of migraines includes:

Prevention

  • Don’t skip meals
  • Avoidance of caffeine
  • Exercise
  • Get plenty of sleep

Medications

For pain:

  • Tylenol, ibuprofen, or naproxen
  • Triptan medication e.g. sumatriptan

For prevention: if migraines occur too often, your child’s doctor might recommend medications to prevent them. Examples include:

  • Ciproheptidine
  • Robiflavin
  • Coenzyme Q10
  • Anti-seizure medications
  • Certain blood pressure medications e.g. propanolol

Behavioral therapy can also help with the treatment of migraines.

Check in with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person if…

Your child experiences worrisome headache symptoms, like:

  • Sudden and severe pain
  • Awakens your child from sleep
  • Associated with fever and neck pain
  • Located in the back of the head or persistently in one spot
  • Progressively worse over time
  • Worse when lying down, coughing, defecating or when active
  • No improvement with medications
  • Associated with vision changes or weakness of any part of the body
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.