Tele-triage for Migraine in Children

Audience: pediatric

Migraines in children can cause severe headaches along with other symptoms like nausea, vomiting, and sensitivity to light or sound. Telemedicine can help families understand when a child's migraine needs urgent care and when it can be managed at home or with remote guidance. During a tele-triage visit, healthcare providers assess symptoms, offer advice on managing pain, and help decide if in-person evaluation is necessary. However, some migraine symptoms may signal a more serious condition requiring immediate medical attention. This guide explains how telemedicine can support families dealing with pediatric migraines, what signs to watch for, and how to prepare for a tele-visit. Always seek emergency care if your child has sudden severe headache, changes in consciousness, or other red flags.

Red flags — go in person / ER

• Sudden, severe headache unlike previous headaches — seek emergency care immediately.
• Weakness, numbness, difficulty speaking, or confusion — call emergency services without delay.
• High fever with stiff neck — requires urgent medical evaluation.

What telemedicine can do

• Assessing typical migraine symptoms and history.
• Providing advice on symptom management and lifestyle changes.
• Determining if in-person care is needed.
• Monitoring response to treatment over time.

What telemedicine cannot do

• Diagnosing serious neurological emergencies.
• Performing physical examinations that require hands-on assessment.
• Ordering immediate imaging or lab tests.
• Managing severe or worsening symptoms that require urgent intervention.

What is a Pediatric Migraine?

A migraine is a type of headache that can cause intense throbbing or pulsing pain, often on one side of the head. In children, migraines may also include nausea, vomiting, dizziness, and sensitivity to light or sound. Migraines can last from one hour to several days and may affect a child's ability to attend school or participate in activities.

How Telemedicine Helps with Migraines

Telemedicine allows healthcare providers to evaluate your child's symptoms through video or phone calls. They can help identify if the headache fits common migraine patterns and suggest ways to relieve pain at home. Tele-triage can guide you on when to use medications, lifestyle changes, or when to seek in-person care. This approach is convenient and reduces the need for travel, especially when symptoms are mild or typical.

When to Seek In-Person Care Immediately

Some symptoms require urgent medical evaluation. If your child experiences any of the following, seek emergency care right away:

These signs may indicate serious conditions beyond migraine.

Preparing for a Telemedicine Visit

Before your tele-visit, gather information to help the provider:

Being ready helps the provider give the best advice.

Managing Migraines at Home

For typical migraines, home care may include:

Always follow your healthcare provider's instructions.

How to prepare for your tele-visit

• Note the onset, frequency, and duration of headaches.
• List all symptoms accompanying the headache.
• Prepare a list of current medications and any allergies.
• Find a quiet, well-lit place for the tele-visit.
• Ensure your device has a stable internet or phone connection.
• Have a caregiver present if the child is very young or unable to communicate well.

After your tele-visit

• Follow the healthcare provider's advice on medication and home care.
• Monitor your child's symptoms and note any changes.
• Schedule follow-up telemedicine visits if recommended.
• Seek in-person care if red flag symptoms develop.
• Keep a headache diary to track frequency and triggers.

FAQs

Can telemedicine diagnose my child's migraine?

Telemedicine can help assess symptoms and suggest if they fit common migraine patterns, but it cannot replace a full physical examination or tests that may be needed in some cases.

What should I do if my child's headache gets worse during the tele-visit?

If your child's symptoms worsen or new concerning signs appear during the tele-visit, inform the healthcare provider immediately. You may need to seek in-person emergency care.

Are there any triggers I should avoid to prevent migraines in my child?

Common triggers include certain foods (like chocolate or caffeine), dehydration, stress, lack of sleep, and bright lights. Identifying and avoiding these can help reduce migraine frequency.

When is it safe to use over-the-counter pain relievers for my child's migraine?

Use over-the-counter pain relievers as advised by your healthcare provider. Avoid giving aspirin to children due to the risk of Reye's syndrome. Always follow dosing instructions carefully.

Can telemedicine replace all in-person visits for migraines?

Telemedicine is useful for many aspects of migraine care but cannot replace in-person visits when physical exams, imaging, or urgent interventions are needed.

Sources

1. Migraine in Children — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Headache and Migraine — Centers for Disease Control and Prevention (CDC).
3. Migraines in Children and Teens — American Academy of Pediatrics (AAP).
4. Migraine — Mayo Clinic.

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