Pediatric migraine: abortive management in the emergency department

Headache. 2014 Feb;54(2):235-45. doi: 10.1111/head.12253. Epub 2013 Oct 29.

Abstract

Studies suggest that headache accounts for approximately 1% of pediatric emergency department (ED) visits. ED physicians must distinguish between primary headaches, such as a tension or migraine, and secondary headaches caused by systemic disease including neoplasm, infection, or intracranial hemorrhage. A recent study found that 40% of children presenting to the ED with headache were diagnosed with a primary headache, and 75% of these were migraine. Once the diagnosis of migraine has been made, the ED physician is faced with the challenge of determining appropriate abortive treatment. This review summarizes the most recent literature on pediatric migraine with an emphasis on diagnosis and abortive treatment in the ED.

Keywords: abortive; emergency department; migraine; pediatric.

Publication types

  • Review

MeSH terms

  • Acetaminophen / therapeutic use
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Child
  • Child, Preschool
  • Dopamine Antagonists / therapeutic use
  • Emergency Service, Hospital*
  • Humans
  • Migraine Disorders / diagnosis*
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / epidemiology
  • Prevalence
  • Serotonin Receptor Agonists / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Dopamine Antagonists
  • Serotonin Receptor Agonists
  • Acetaminophen