What is the outlook for children and adolescents with migraine?

Treatment helps most children and adolescents with migraine. Fifty percent of children and adolescents report migraine improvement within 6 months after treatment. However, in about 60% of adolescents who experience their first migraine as an adolescent, the migraine may continue off and on for many years.

It should be noted that many of the medications listed in this handout have not been approved by the by the Food and Drug Administration (FDA) for use in children and adolescents with headaches. This is a common practice in the field of medicine and is called ‘off-label’ prescribing. It is one of the ways new and important uses are found for already approved drugs. Many times, positive findings lead to formal clinical trials of the drug for new conditions and indications.

Rehabilitation program. Some hospitals and/or other health care facilities offer inpatient headache management programs for children and adolescents; ask your doctor if their facility offers such programs.

Patients typically accepted into these programs are those who have a chronic daily headache (greater than 15 days a month), missed an excessive amount of school, have overused over-the-counter medications, and have headache pain that is controlling their lives. The staff of such programs can include psychologists, pediatric rehabilitation specialists, occupational and physical therapists as well as access to a child psychiatrist. Stress factors are an important focus of this program; not rapid changes in medications.

Clinical trials. Some children and adolescents with migraine don’t experience headache relief despite trying many of the currently available medications. If this is the case for your child, ask your doctor about possible participation in a clinical trial. Clinical trials provide access to drugs not yet approved by the FDA. Such drugs are not available through “regular” doctors’ offices; they are only available through doctors and health care organizations that have agreed to participate in the clinical trials. Your doctor will help determine if your child is an appropriate candidate for this type of research study.

Last reviewed by a Cleveland Clinic medical professional on 08/25/2017.

References

  • Cleves C, Rothner AD. Headache in Children and Adolescents: Evaluation and Diagnosis, including Migraine and its Subtypes. Chapter 6. In: Tepper SJ, Tepper DE, eds. The Cleveland Clinic Manual of Headache Therapy. New York: Springer 2011:81-92.
  • Cleves C, Rothner AD. Diagnosis of Childhood Periodic Syndromes, Tension-Type Headaches, and Daily Headache Syndromes. Chapter 7. In: Tepper SJ, Tepper DE, eds. The Cleveland Clinic Manual of Headache Therapy. New York: Springer 2011:93-103.
  • Rothner AD. Treatment of Pediatric and Adolescent Headaches. Chapter 15. In: Tepper SJ, Tepper DE, eds. The Cleveland Clinic Manual of Headache Therapy. New York: Springer 2011:209-24.
  • National Headache Foundation. Migraine. Accessed 3/27/2017.
  • American Migraine Foundation. Migraine in Children. Accessed 04/26/2019.

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