Treatment Options for Migraine Headache

Preventive Strategies for Migraine Headaches in Children

Preventive treatment for children and adolescents include:

• Careful evaluation of diet in order to avoid foods that most commonly trigger headaches, including:

  • Tyramine and phenylethlamines - found in some dairy products, chocolate, and citrus fruit
  • Nitrates and nitrites - found in preserved meats such as deli
  • MSG - a flavor enhancer(e.g. Accent) found in many processed foods
  • Caffeinated beverages - such as coffee, tea, cola beverages. Excessive amounts of caffeine as well as withdrawal from excessive amounts may trigger headaches. Also ingestion of certain alcoholic beverages, especially red wine, may trigger attacks.
  • Some fruits may trigger attacks such as bananas, citrus fruits, avocados, or plums. It is important, though, to ensure that the child still eat a healthy diet despite the omission of these foods (if they have been identified as triggers)

• Examination of drugs children or adolescents may be taking that can trigger headaches such as cimetidine (Tagamet), estrogen (Premarin), or ranitidine (Zantac)

• Awareness of environmental sources such as bright or flickering lights, high altitude, strong odors, fatigue, complex visual patterns such as zigzagging lines, or body motion (such as travel). Motion seems to be a trigger especially for little children.
• Minimize exertion such as sports if associated with onset of migraines
• Be sure they eat regularly and get sufficient sleep
• Treat comorbid psychological issues such as depression, stress, sadness, or anxiety

Currently, there are no medications that have been approved by the FDA for prophylaxis of migraines in children. However, various studies have indicated that topiramate (Topamax), valproic acid (Depakote), flunarizine, amitriptyline (Elavil), and cyproheptadine (Periactin) have shown efficacy in reducing the frequency and duration of migraine headaches in children.