Certainly. Below is a comprehensive treatment plan for a 13-year-old male presenting with headache, based on the provided information and current evidence-based guidelines.

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## 1. Primary Diagnosis

**Provisional Diagnosis:**  
*Primary headache disorder* (most likely migraine or tension-type headache), pending further evaluation.

**Note:**  
Secondary causes must be excluded, especially in the presence of red flags or abnormal findings.

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## 2. Treatment Goals

- Relieve acute headache symptoms
- Prevent recurrence and reduce headache frequency/severity
- Minimize medication side effects and risk of medication overuse headache
- Identify and manage potential triggers
- Maintain normal school attendance and activities
- Monitor for development of red flag symptoms

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## 3. Medication Recommendations

**A. Acute (Abortive) Treatment**  
*For infrequent, moderate-to-severe headaches interfering with activities:*

- **Acetaminophen (Paracetamol):**  
  - Dose: 10–15 mg/kg per dose, every 4–6 hours as needed (max 75 mg/kg/day; do not exceed 4 g/day)
- **Ibuprofen:**  
  - Dose: 10 mg/kg per dose, every 6–8 hours as needed (max 40 mg/kg/day; do not exceed 2.4 g/day)
- **Consider triptans** (e.g., sumatriptan nasal spray) if migraine is diagnosed and refractory to above, under specialist guidance.

**B. Preventive (Prophylactic) Treatment**  
*Not indicated unless headaches are frequent (>4/month), disabling, or not responsive to acute therapy. If needed, options include:*

- **Amitriptyline:** 0.25–1 mg/kg at bedtime (start low, titrate up)
- **Topiramate or propranolol:** Consider in consultation with pediatric neurology

**C. Avoid:**
- Opioids and combination analgesics (risk of overuse and side effects)
- Frequent use of acute medications (>2–3 days/week) to prevent medication overuse headache

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## 4. Non-Pharmacological Interventions

- **Headache diary:** Track frequency, duration, triggers, and response to treatment
- **Lifestyle modifications:**
  - Regular sleep schedule
  - Hydration (adequate fluid intake)
  - Balanced diet, regular meals
  - Regular physical activity
  - Stress management/relaxation techniques (e.g., cognitive-behavioral therapy, biofeedback)
- **Trigger identification and avoidance:** e.g., certain foods, dehydration, stress, screen time
- **Vision assessment:** Ensure up-to-date vision correction if needed

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## 5. Follow-up Schedule

- **Initial follow-up:** 2–4 weeks after starting treatment or sooner if symptoms worsen
- **Ongoing:** Every 3–6 months if stable, or as needed based on symptom control
- **Urgent review:** If red flag symptoms develop or headaches worsen/progress

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## 6. Monitoring Parameters

- Headache frequency, duration, and severity (via diary)
- Medication use (to avoid overuse)
- Side effects of medications
- School attendance and participation in activities
- Signs of secondary headache (see red flags below)

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## 7. Patient Education Points

- Importance of keeping a headache diary
- Recognizing and avoiding triggers
- Proper use of medications (dose, frequency, risks of overuse)
- When to seek urgent medical attention (see red flags)
- Role of lifestyle factors in headache management
- Reassurance regarding prognosis (most primary headaches improve with age and management)

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## 8. Potential Complications to Watch For

- **Medication overuse headache** (from frequent analgesic use)
- **Progression to chronic daily headache**
- **Development of red flag symptoms** (suggesting secondary cause):
  - Sudden, severe headache
  - Headache with fever, neck stiffness, altered mental status, or visual changes
  - Focal neurological deficits
  - Persistent vomiting
  - Headache worsening with Valsalva or lying down
  - Recent head trauma
- **Impaired school performance or attendance**
- **Psychological impact** (anxiety, depression)

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**Note:**  
This plan is based on initial presentation and should be adapted as more clinical information becomes available. Always recommend a thorough evaluation by a healthcare professional to confirm diagnosis and guide management.

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**References:**
- American Academy of Neurology/Child Neurology Society Guidelines: Pharmacologic Treatment of Pediatric Migraine Headache (2019)
- NICE Clinical Knowledge Summaries: Headache – children
- UpToDate: Approach to the child with headache

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**Consultation with a pediatrician or pediatric neurologist is recommended for confirmation of diagnosis, ongoing management, and if any red flags or atypical features are present.**