HEADACHES/ MIGRANES
HISTORY
- Age of onset
- Trauma?
- Change in weight?
- Neurological symptoms? Vision symptoms.
- Frequency/ severity/ Duration
- Family history
- Stressors
DIAGNOSTIC CRITERIA FOR PAEDIATRIC MIGRAINE( NO AURA)
TREATMENT
IN ACUTE SYMPTOMATIC
- Nonsteroidal Anti-inflammatory drugs-
- Ibuprofen (Per oral- 10mg/kg/dose- max 30mg/kg/day)
- Naproxen ( Per oral-5 mg/kg twice daily- max 1 gram)
- Acetaminophen( Per oral-15 mg/kg/day)
- Triptans-
- Sumatriptans(per oral 6-10 years- 25mg single dose/ 10-12 years- 50 mg single dose/ 12-18 years- upto 100 mg single dose)
- Rizatriptans
- Antiemetics-
- Metocloperamide(per oral/ IM/ IV-100-150 microgram/kg TID)
- Prochlorperazine(Per oral- 250microgram/ kg TID)
- Promethazine( Per oral- 5 mg once daily in 2-5 years/ 10 mg once daily in 5-10 years/ 20 mg once daily in 10-18 years)
- Magnesium
- Steroids( Methyl prednislone)
- Sodium valproate
IN CHRONIC CONDITIONS( >3 EPISODES/ MONTH)
- Amytriptyline-( 200-500 microgram/ kg- max 10 mg once daily)
- Cyproheptadine
- Propranolol
- Flumarizine