How is acute migraine treated in children?

Updated: Jan 31, 2018
  • Author: William C Robertson, Jr, MD; Chief Editor: Amy Kao, MD  more...
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Answer

Answer

During the attack, advise the child to lie down in a cool, dark, quiet room and go to sleep at the time of the attack. Sleep is the most potent antimigraine treatment. During a migrainous attack, a child commonly can be found resting in the fetal position with the affected side of the head down.

Children should be given simple analgesics such as acetaminophen or ibuprofen. They should be taught to "give in" to their headache because activity will probably aggravate their pain. Promethazine or compazine diminishes nausea, causes drowsiness, and seems to decrease pain; therefore, it frequently is used as a rescue medication.

Some patients find that ice or pressure on the affected artery can temporarily alleviate pain. NSAIDs are effective if taken at a high, but appropriate, dosage during the aura or early headache phase. Gastric stasis occurs in most migraine patients and causes delay in absorption of oral medications. Occasionally, carbonated beverages may improve absorption.

Nonpharmacologic treatment modalities such as self-relaxation, biofeedback, and self-hypnosis may be reasonable alternatives to pharmacologic treatment in managing childhood migraine, particularly in adolescents. Response rates in children tend to be higher than in adults and show continued effectiveness over time.


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