ED Guidelines for Evaluation/Treatment of the Child with Migraine Headache

Complete History and Physical Examination

History

Characteristics of Headache

Location
Quality
Duration

Associated Symptoms

Nausea/vomiting
Photophobia/phonophobia
Visual changes, aura
Paresthesias, weakness

Headache Triggers

Diet (caffeine, etc.)
Medications (OCP, retinoic acid, tetracycline)
Menstrual cycle (LMP)

Other Causes

Trauma
Infectious diseases
SHADDS
VP Shunt

Analgesia

Dosing, frequency, type of medication used for current headache
Medications that were previously successful

Physical Exam