The most important step in migraine management is to keep an accurate diary and drawings of the migraine episodes. Information that needs to be included in the diary is outlined in another blog entry. Since the diary will be completed during the headache it will be written by a parent. There should be at least six lines for each headache and it should be written in narrative form as if you were writing a newspaper article. In general answers need to be provided to the W’s: when, what, where, who and why. The child or teen can make of drawing of the headache after the headache has improved.
Look for triggers and patterns. Avoid any dietary or lifestyle triggers. Your child needs a healthy lifestyle in terms of sleep, activity and dietary intake. If your child is not getting 8-10 hours of sleep a night and their sleep schedule is not consistent 7 days a week then make changes. Sleeping in on weekends and fatigue in the am requiring assistance to wake up need to be eliminated. The same sleep and wake schedule should be followed 7 days a week. Too much or too little activity and exercise will set off a migraine. A healthy balanced diet is essential and breakfast is as important as everyone says.
Try to recognize signs that a headache is coming. These are called premonitory signs and can allow you to recognize and treat a headache early. You must treat a migraine early and aggressively to have success. Waiting until there is superficial facial pain (cutaneous allodynia) decreases response from 90% to 40-50%.