Migraine Headache Clinical Pathway — Emergency Department
Migraine Headache Clinical Pathway — Emergency Department
Complete History and Physical Exam
Characteristics of Headache | Location Quality Onset, duration Headache frequency prior to this episode |
---|---|
Associated Symptoms | Nausea/vomiting Photophobia/phonophobia Auras are less common in children Most common: visual disturbances, unilateral paresthesias |
Red Flags | Seizure, weakness, focal neurologic sign/symptom Thunderclap onset Rapid progression of headache |
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
- Vital signs, complete neurologic exam including fundoscopic exam
- Signs of infectious disease, trauma, rheumatologic diseases