Last reviewed: 30 Sep 2024
Last updated: 24 Aug 2023
Summary
Definition
History and exam
Key diagnostic factors
- age >2 years
- gradual onset of headache
- normal physical examination
Full details
Other diagnostic factors
- aura
- nausea and/or vomiting
- visual disturbance
- phonophobia
- occipital headache, ataxia, diplopia, blurred vision, vertigo, and tinnitus
- unilateral motor or sensory signs and headache
- ptosis
- generalized seizure
Full details
Risk factors
- positive family history of migraine
- chocolate, cheese, and citrus fruits
- stress
- hormonal changes
- alcohol and caffeine
- volume depletion
- overuse of analgesics
- sleep disturbance
- bright or flickering lights
- periodic syndromes
Full details
Diagnostic tests
1st tests to order
- no initial test
Full details
Tests to consider
- brain CT/MRI
Full details
Treatment algorithm
ACUTE
acute episode
ONGOING
frequency and severity of attack has an impact on quality of life and school attendance
Contributors
Authors
Nick Barnes, MBBS, BSc, MRCP, MRCPCH
Consultant Paediatrician
Northampton General Hospital
Northampton
UK
Disclosures
NB declares that he has no competing interests.
Peer reviewers
Kenneth Mack, MD, PhD
Medical Director
Mayo Clinic Pediatric Center
Rochester
MN
Disclosures
KM declares that he has no competing interests.
Tony McShane, MBBS
Consultant Paediatric Neurologist
John Radcliffe Hospital
Oxford
UK
Disclosures
TM declares that he has no competing interests.
Sandeep Jayawant, MBBS
Consultant Paediatric Neurologist
John Radcliffe Hospital
Oxford
UK
Disclosures
SJ declares that he has no competing interests.
Howard S. Jacobs, MD
Associate Professor
Co-Director Pediatric Headache Clinic
University of Maryland School of Medicine
Baltimore
MD
Disclosures
HSJ declares that he has no competing interests.
Differentials
- Cluster headache
- Tension headache
- Posttraumatic headache
More DifferentialsGuidelines
- Practice guideline update: acute treatment of migraine in children and adolescents
- Practice guideline update: pharmacologic treatment for pediatric migraine prevention
More GuidelinesPatient information
Migraine in children
Migraine in children: medications to prevent attacks
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