skip to main content

Migraine – prophylaxis — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNeurologyMigraine – prophylaxisRACP Paediatrics

A 12-year-old has been having 6-8 migraine attacks per month that are significantly affecting school attendance. Simple analgesics provide partial relief. What is the most appropriate prophylactic medication?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Propranolol

For children with frequent migraines (≥4/month) causing significant disability, prophylactic therapy should be considered. Propranolol is a commonly used first-line prophylactic agent in children. Other options include amitriptyline, topiramate, and flunarizine. A trial of 2-3 months is needed to assess efficacy. Lifestyle measures (sleep hygiene, regular meals, exercise, stress management) should be optimised concurrently.

Reference: RCH Melbourne – 2023 – Headache CPG; Australian Therapeutic Guidelines – 2024 – Neurology