The Office of Evidence Based Practice is currently revising this CPG; if you have any recommendations for improving this CPG, please forward to Dr. J. Michael, EBP Medical Director, at


Migraine in the ED/UCC

Inclusion criteria: This guideline is intended to be used as a diagnostic and treatment tool in children and adolescents with acute headache consistent with migraine.

Exclusion criteria: This guideline is not intended for use with children who are less than five years of age or who have an exam not consistent with a primary headache; or have an abnormal neurologic examination.  

Click on blue shapes for more in-depth information.


Algorithm Legend

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.

Patient's Pain Assessed to be >3Discharge Recommendations & Follow UpCan Patient be DischargedOther Medications to ConsiderValproic AcidDischarge Recommendations & Follow UpCan Patient be DischargedProchlorperazinewith or without DiphenhydrAMINEDecrease Enviromental StimuliIV FluidsDischarge Recommendations & Follow UpHeadache TreatmentComplete History & Physical ExamMigraine Therapy in the ED

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