Treatment Options for Migraine Headache

Treatment of Migraine Headaches in Children and Adolescents

Sleep is actually the best treatment for migraines in children as it relieves pain, alleviates most symptoms, and appears to restore normal brain function. Treatment for children includes:

• Educating children about migraine headache and triggers
• Immediate relief of acute headache

Education

Children should be taught to identify triggers, to get proper rest, to eat regularly, and not to overload their schedule since management of these issues seems to be highly effective for preventing headaches. Like with adults, keeping headache diaries can help children keep track of factors leading up to an attack and identifying what was most effective in aborting the attack.

Relief of Acute Headache

Effective methods for aborting an acute migraine headache in children include:

• Sleep - this is the most effective relief from acute migraine attacks. The child should lie down in a cool, dark place and sleep. Many children sleep in a fetal position with the painful side of their head down.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) - such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) tend to be effective when taken at high doses during the aura or early in the course of the headache. Caution is needed regarding the amount and frequency of medication since overuse of NSAIDs may be a cause of rebound headache.

• Migraine specific drugs are used cautiously for children and include:

  • triptans [sumatriptan (Imitrex), zolmitriptan (Zomig) and eletriptan (Relpax)]
  • if triptans are not effective, some children find relief from ergotamine tartrate (Cafergot), or dihydroergotamine (DHE 45 injection or Migranal nasal spray)

Children with status migrainous may need to be treated in the doctor's office or the emergency room with intravenous or intramuscular medications.