Red flags & when to go in person for Migraine

Audience: pediatric

Migraines in children can cause severe headaches and other symptoms like nausea, light sensitivity, and difficulty concentrating. While many migraines can be managed at home or with telemedicine support, some signs mean your child needs to see a healthcare provider in person quickly. These include sudden, very severe headaches, changes in vision, weakness, or confusion. Telemedicine can help assess symptoms, provide advice, and suggest treatments, but it cannot perform physical exams or emergency care. Knowing when to seek in-person care helps keep your child safe and ensures they get the right treatment. This guide explains red flags to watch for, how telemedicine can support migraine care, and what to prepare before a virtual visit.

Red flags — go in person / ER

• Sudden, severe headache unlike any before — seek emergency care immediately.
• Weakness, numbness, difficulty speaking, or confusion — go to emergency services.
• High fever with stiff neck or headache after head injury — get urgent medical evaluation.

What telemedicine can do

• Initial symptom assessment and history taking
• Providing advice on managing mild to moderate migraines
• Guidance on medication use and lifestyle changes
• Determining if urgent in-person care is needed

What telemedicine cannot do

• Physical neurological examination
• Emergency treatment for severe symptoms
• Imaging tests like CT or MRI scans
• Administering medications or procedures in person

What is a Migraine in Children?

A migraine is a type of headache that can cause intense pain, often on one side of the head. Children may also feel sick to their stomach, be sensitive to light or sound, or have trouble focusing. Migraines can last from a few hours to several days and may affect school and daily activities.

Common Migraine Symptoms

\1

Red Flags: When to Seek In-Person Care Immediately

Certain signs mean your child needs urgent medical attention:

If any of these happen, go to the nearest emergency room or urgent care center.

How Telemedicine Can Help

Telemedicine allows you to talk with a healthcare provider through video or phone. They can:

However, telemedicine cannot perform physical exams or emergency treatments.

Preparing for a Telemedicine Visit

To get the most from a virtual visit:

After the Telemedicine Visit

Follow the provider's advice carefully. This may include:

How to prepare for your tele-visit

• List your child's migraine symptoms and when they started
• Note any medicines or supplements your child is taking
• Prepare a quiet, private space with good lighting for the visit
• Have a way to write down the provider's advice
• Be ready to describe any recent injuries, illnesses, or changes in behavior

After your tele-visit

• Follow the provider's instructions on medicines and care
• Watch for any worsening symptoms or new red flags
• Schedule follow-up appointments if recommended
• Keep a headache diary to track symptoms and triggers
• Seek in-person care if advised or if red flags develop

FAQs

Can telemedicine diagnose my child's migraine?

Telemedicine providers can ask about symptoms and help decide if your child likely has migraines, but they cannot perform physical exams or tests needed for a full diagnosis.

When should I take my child to the emergency room for a headache?

If your child has a sudden, very severe headache, weakness, confusion, difficulty speaking, high fever with stiff neck, or headache after a head injury, seek emergency care immediately.

What can I do at home to help my child during a migraine?

Encourage rest in a quiet, dark room, offer fluids, and use any medicines recommended by your healthcare provider. Avoid triggers like bright lights or loud noises.

Are migraines common in children?

Yes, migraines can affect children and adolescents. They often run in families and may change as your child grows.

Can telemedicine providers prescribe migraine medicines?

Depending on local regulations, telemedicine providers may recommend or prescribe medicines, but some medications may require in-person evaluation.

Sources

1. Migraine in Children — MedlinePlus, U.S. National Library of Medicine.
2. Migraine Overview — Mayo Clinic.
3. Headache in Children and Adolescents — American Academy of Pediatrics.
4. Migraine — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child shows any red flags or you are concerned about their health, seek immediate medical attention.