Clinical Scenario

Age < 18 years

This protocol applies to paediatric patients — children and adolescents under 18 years of age — presenting with migraine without aura. Patient age is the primary determinant of which acute treatments are appropriate and which options carry formal regulatory approval within this population.

Treatment Approach

Acute treatment selection depends on the patient's age within the paediatric range. For adolescents 12 years and older who have not had an adequate response to initial acute therapy, a targeted class of acute migraine-specific agents — triptans — is supported by sufficient clinical evidence and carries regulatory approval for select formulations in this age group. The complete protocol specifies which agents are indicated, the clinical criteria for their use, and the full treatment decision pathway.

References

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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Treatment of Migraine Without Aura in Children and Adolescents Under 18 Years

References