Neurology

Migraine

2 templates in the library cover this condition: Migraine, follow-up and Migraine.

This template hands off to

Headache

Comes up in this visit

Contraception

Built from the same sources

Chest pain Murmur Syncope

Template

Migraine, follow-up

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MonthChoose anyFirst line

StatusChoose oneFirst line

FrequencyChoose one

Headache daysChoose one

Acute medicine useChoose one

TriggersChoose any

Prevention side effectsChoose one

Acute responseChoose one

Red flags presentChoose any

Red flags absentChoose any

Headache careChoose any

Medication planChoose one

TriptanChoose one

NauseaChoose any

Overuse counselingChoose any

ImagingChoose any

Additional planChoose any

Testing and referral statusChoose any

NeurologyChoose one

DispositionChoose one

Follow-upChoose one

Follow-up reasonChoose anyJoins the line above

Counseling paragraphChoose oneParagraph

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Migraine, follow-up
November 2026: Doing well.
• Migraine frequency improved
• Using acute medicines a few days a month without overuse
• No change in pattern, new neurologic symptoms, or waking from sleep with vomiting
• Continue headache hygiene with regular sleep, meals, water, exercise, and limited screens before bed
• No medication change planned at this time
• Neurology referral if migraines are not improving with these measures
• Follow up in 3 months or sooner as needed to review the response to treatment

Migraines usually become less frequent with steady sleep, meals, water, and exercise, and acute medicines work best at the first sign of a headache. Recommended supportive care with motrin or tylenol as needed with an emphasis on taking medicine early, resting in a dark, quiet room, and tracking headaches. Return precautions given including the worst headache ever, a headache with fever and a stiff neck, new weakness or trouble walking, vision loss, waking from sleep with vomiting, a headache that is different from usual, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Headache days a month by diary
Medication overuse
Acute response; triptans
Red flags present or absent
Continue headache hygiene
Prevention plan with taper
Diary, overuse counseling, CBT, Topiramate counseling, school letter, MRI

Return precautions in the template

the worst headache evera headache with fever and a stiff necknew weakness or trouble walkingvision losswaking from sleep with vomitinga headache that is different from usual

Sources

Pediatric Care Online: Headache
HealthyChildren.org: Migraine Headaches in Kids
HealthyChildren.org: Dizziness and Fainting in Children and Teens
The Cribsiders: #60, Pediatric Headaches: Making Them Less Aura-ble (August 17, 2022)
AAN practice guideline updates, pediatric migraine (status pages on aan.com; clinician summary PDFs downloaded but their text could not be extracted)
CDC Yellow Book 2026, Motion Sickness (page dated April 23, 2025)
Contraceptive Counseling and Methods for Adolescents: Clinical Report. Pediatrics 2025;156(1):e2025072218. (current; companion to policy)

Template

Migraine

Tap a choice or type a Repertoire Line to see how the note changes. Defaults are what the template inserts on its own.

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AuraChoose oneFirst line

DiagnosisChoose one

Family historyChoose any

Red flags presentChoose any

Red flags absentChoose any

ExamChoose one

ImagingChoose one

Acute planChoose any

TriptanChoose one

NauseaChoose any

LifestyleChoose any

PreventionChoose one

Additional planChoose any

NeurologyChoose one

DispositionChoose one

Follow-upChoose one

Follow-up reasonChoose anyJoins the line above

Counseling

Migraines often run in families and usually improve with regular routines and early treatment. Recommended supportive care with motrin or tylenol at the first sign of a migraine, with an emphasis on rest in a dark, quiet room, fluids, regular sleep and meals, and limiting pain medicine to a few days a week. Return precautions given including a sudden severe headache, a headache that is different from the usual migraines, weakness or numbness that does not go away, vision loss, trouble walking or talking, fever with a stiff neck, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Migraine
• History consistent with migraine: recurrent throbbing headaches with nausea or light and sound sensitivity
• No sudden severe onset, a change from the usual pattern, neurologic symptoms beyond the typical aura, waking from sleep with vomiting, fever with neck stiffness, or headache with coughing or straining
• Neurologic exam reassuring
• Head imaging not indicated given a typical migraine history and reassuring neurologic exam
• Recommended motrin or tylenol at the first sign of a migraine, with fluids, rest in a dark, quiet room, and benadryl if needed
• Migraine hygiene reviewed with an emphasis on regular sleep, regular meals, hydration, exercise, stress management, and known triggers
• Recommended a headache diary to track frequency, triggers, and response to treatment
• Daily prevention not needed given infrequent migraines with little effect on school or activities
• Neurology referral if migraines are not improving with these measures
• Follow up if not improving

Migraines often run in families and usually improve with regular routines and early treatment. Recommended supportive care with motrin or tylenol at the first sign of a migraine, with an emphasis on rest in a dark, quiet room, fluids, regular sleep and meals, and limiting pain medicine to a few days a week. Return precautions given including a sudden severe headache, a headache that is different from the usual migraines, weakness or numbness that does not go away, vision loss, trouble walking or talking, fever with a stiff neck, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Aura (with or without)
Family history
Red flags present or absent
No imaging vs MRI
Acute plan with motrin or tylenol, fluids, dark room, benadryl
Triptan: Rizatriptan, Sumatriptan nasal, Sumatriptan
Migraine hygiene; diary
Prevention: none, riboflavin and magnesium, Cyproheptadine, Topiramate, Propranolol, Amitriptyline
Limit acute medicine; school letter; CBT; Topiramate pregnancy counseling
ED for red flags

Return precautions in the template

a sudden severe headachea headache that is different from the usual migrainesweakness or numbness that does not go awayvision losstrouble walking or talkingfever with a stiff neck

Sources

Few formal guidelines cover this topic, so the template also leans on expert opinion.