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Migraine — RACP Paediatrics MCQ

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EasyNeurology & DevelopmentMigraineRACP Paediatrics

A 14-year-old girl presents with a severe throbbing unilateral headache associated with nausea, vomiting, photophobia, and phonophobia lasting 6 hours. She has had 5 similar episodes in the past 3 months. What is the most appropriate acute treatment?

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Correct answer: B — Paracetamol 15 mg/kg and ibuprofen 10 mg/kg

Simple analgesics (paracetamol 15 mg/kg and/or ibuprofen 10 mg/kg) are first-line acute treatment for migraine in children and adolescents. They should be given early in the attack. Triptans (e.g. sumatriptan nasal spray) are second-line if simple analgesics fail. Opioids are not recommended. Topiramate is a prophylactic agent, not an acute treatment.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Headache