What is the role of medications in the treatment of childhood migraine variants (equivalents)?

Updated: Nov 19, 2019
  • Author: Wendy G Mitchell, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP, FANA  more...
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Answer

Acute treatment (symptomatic therapy) terminates the migraine variant episode. Prophylactic treatment prevents episodes or reduces their number or severity. Medications used to treat or abort attacks include antiemetics, ergot alkaloids, serotonin agonists, and nonsteroidal anti-inflammatory drugs (NSAIDs).

Minor analgesics, with or without antiemetics or caffeine, are useful in most children. Avoid narcotics and sedatives in most patients. Some of the prophylactic medications that are effective in some patients with migraine variants include low-dose aspirin, beta blockers, low-dose tricyclic antidepressants (TCAs), cyproheptadine, calcium channel blockers, and low-dose anticonvulsants, including valproic acid and topiramate. Acetazolamide (Diamox) is useful for selected patients with hemiplegic migraine due to specific channelopathies.


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