Pediatric Migraine Clinical Pathways

Status migrainosus refers to a debilitating continuous headache lasting longer than 72 hours and/or a headache for which multiple acute abortive treatments have failed prior to presenting to Children’s Hospital Colorado.

About the pediatric migraine clinical pathways

These migraine clinical pathways offer best practice recommendations for pediatric patients suffering from status migrainosus. They were created by our multidisciplinary team of content experts, including primary care, emergency, neurology, hospitalist, nursing and pharmacy providers and process improvement professionals from available published literature and integrated local expert opinion when necessary.

Objectives of the pediatric migraine pathways include:

• Offering seamless care of the migraine patient accessing care across the system
• Decreasing risk of missing secondary causes for migraine headaches
• Helping guide the decision-making process for standardized, evidence-based care

Access our clinical pathways for pediatric migraine treatment

Use the links below to access the pathways on AgileMD.

• Migraine | ED/UC
• Migraine | Inpatient

Primary versus secondary headache: understanding response to migraine treatment

Diagnostic criteria for migraine: >/= 5 distinct headache attacks with >/= 2 features (bilateral, moderate to severe, aggravated by exertion, pulsating/throbbing) and at least one of the following: nausea, vomiting, phonophobia, photophobia and not better explained by another cause.

Migraine headache is a primary headache disorder. Secondary headaches arising from intracranial infection, hemorrhage, venous thrombus and other pathologies may share similar characteristics with migraine headache and may improve with medications in this pathway.

Response to medications in this pathway should not be used as evidence to support the diagnosis of migraine headache. In patients without a firmly established diagnosis of migraine headache, careful consideration of other pathologies is warranted.