Treatment of Vestibular Migraine in Patients Younger Than 18 Years
Managing an acute vestibular migraine attack in children and adolescents requires careful attention to age-specific medication selection. This protocol covers the appropriate first-line approach for patients under 18 years of age.
Clinical Scenario
Patient age is younger than 18 years. Age directly determines which analgesics are appropriate and how they are dosed during an acute vestibular migraine attack, as not all agents used in adults are suitable for this population.
Treatment Approach (partial overview)
Acute attack management centres on weight-based analgesic therapy, with the specific agent chosen according to the patient's age. When nausea or vomiting accompanies the attack, anti-emetic selection also follows pediatric-specific guidance — the full protocol specifies which agent is appropriate and which should be avoided in this age group.
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).
The use of ASA is not recommended before the age of 12.
If anti-emetics are necessary, domperidone should be used and not metoclopramide, due to the elevated risk of acute extra-pyramidal dystonia with metoclopramide.
View source ↗