Migraine with aura in patients under 18 presents specific clinical considerations. Age determines which acute treatments are appropriate and at what point escalation beyond standard analgesic therapy is indicated.
This protocol applies to children and adolescents younger than 18 years presenting with migraine with aura. In this age group, acute analgesic therapy is the established first approach. When analgesic treatment does not provide sufficient relief, the question of appropriate next-step acute therapy arises — particularly in adolescents.
For adolescents in whom analgesics have not achieved adequate migraine control, a migraine-specific class of acute therapy becomes relevant. Eligibility and the choice among available options within this class depend on age and local regulatory approval.
The complete structured regimen — including which agents apply, age thresholds, and the full decision sequence — is in the protocol below.
DOI: 10.1177/2514183X1882337
Migraine attacks in children are treated with ibuprofen 10 mg/kg body weight (BW), ASA (500 mg) or paracetamol 15 mg/kg BW (second choice).
Sufficient data are available to justify the use of triptans (sumatriptan 10–20 mg as nasal spray, zolmitriptan 2.5–5 mg tablets, rizatriptan 5–10 mg tablets and almotriptan 12.5 mg tablets) in adolescents in case of inadequate response to acute therapy with analgesics.
Sumatriptan 10 mg and zolmitriptan 5 mg as nasal spray are approved for the treatment of migraine in adolescents age 12 or older.
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