Intravenous Migraine Treatment in Children and Adolescents

Curr Pain Headache Rep. 2020 Jul 8;24(8):45. doi: 10.1007/s11916-020-00867-7.


Purpose of review: Pediatric migraine is a common, chronic, and disabling neurological disorder in children and adolescents. Outpatient management is not always effective, and intravenous migraine management may be necessary for headache treatment in the pediatric emergency department. Most current treatment is based on retrospective evidence and there is a lack of well-designed randomized double-blinded controlled pediatric studies. Intravenous drug treatment agents including intravenous fluids, prochlorperazine, diphenhydramine, metoclopramide, dexamethasone, magnesium, valproate and propofol, and dihydroergotamine are reviewed in this paper.

Recent findings: Nineteen studies were reviewed including one prospective randomized double-blind; one single-blinded randomized; one prospective; and one open-label, randomized clinical trial. Most studies were retrospective and the quality of the studies was limited. No definite conclusions can be drawn from the studies, but appropriate prospective trials between major pediatric headache institutions will move pediatric intravenous migraine management forward.

Keywords: Acute treatment; Intravenous treatment; Pediatric migraine; Status migrainosus.

Publication types

  • Review

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Akathisia, Drug-Induced / drug therapy
  • Akathisia, Drug-Induced / etiology
  • Anesthetics, Local / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Basal Ganglia Diseases / chemically induced
  • Basal Ganglia Diseases / drug therapy
  • Child
  • Dexamethasone / therapeutic use
  • Dihydroergotamine / therapeutic use
  • Diphenhydramine / therapeutic use
  • Dopamine Antagonists / therapeutic use*
  • Emergency Service, Hospital
  • Enzyme Inhibitors / therapeutic use
  • Fluid Therapy
  • Glucocorticoids / therapeutic use*
  • Hospitalization
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Ketorolac / therapeutic use
  • Lidocaine / therapeutic use
  • Magnesium / therapeutic use
  • Migraine Disorders / drug therapy*
  • Prochlorperazine / therapeutic use
  • Propofol / therapeutic use
  • Valproic Acid / therapeutic use
  • Vasoconstrictor Agents / therapeutic use


  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal, Humanized
  • Dopamine Antagonists
  • Enzyme Inhibitors
  • Glucocorticoids
  • Hypnotics and Sedatives
  • Vasoconstrictor Agents
  • Dihydroergotamine
  • Valproic Acid
  • Dexamethasone
  • eptinezumab
  • Diphenhydramine
  • Lidocaine
  • Magnesium
  • Prochlorperazine
  • Propofol
  • Ketorolac