Pediatric Migraine: Abortive Management in the Emergency Department

Authors

  • David C. Sheridan MD,

    Corresponding author
    1. Department of Emergency Medicine/Pediatrics, Oregon Health & Science University, Portland, OR, USA
    • Address all correspondence to D.C. Sheridan, Department of Emergency Medicine, Oregon Health & Science University, 707 SW Gaines Road, Portland, OR 97239, USA.

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  • David M. Spiro MD, MPH,

    1. Department of Emergency Medicine/Pediatrics, Oregon Health & Science University, Portland, OR, USA
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  • Garth D. Meckler MD, MSHS

    1. Department of Pediatrics/Division of Emergency Medicine, BC Children's Hospital, Vancouver, BC, Canada
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  • Conflict of Interest: The authors have no financial disclosures or conflicts of interest.

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.

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