Certainly. Here is a comprehensive, structured treatment plan for a 13-year-old male diagnosed with **migraine**:

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## 1. Primary Diagnosis

**Migraine headache** (pediatric/adolescent onset)

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## 2. Treatment Goals

- Rapid relief of acute migraine attacks
- Minimize headache frequency, severity, and duration
- Prevent migraine-related disability (school absence, activity limitation)
- Reduce reliance on acute medications and prevent medication overuse
- Identify and manage triggers
- Monitor for and prevent complications

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## 3. Medication Recommendations

### a. **Acute (Abortive) Treatment**

**First-line:**
- **Acetaminophen**: 15 mg/kg/dose PO, max 1000 mg/dose, every 4–6 hours as needed (max 75 mg/kg/day or 4000 mg/day)
- **Ibuprofen**: 10 mg/kg/dose PO, max 600 mg/dose, every 6–8 hours as needed (max 40 mg/kg/day or 2400 mg/day)

**If inadequate response and diagnosis confirmed:**
- **Triptans** (approved for pediatric use; age restrictions apply):
    - **Sumatriptan nasal spray**: 5–20 mg (start with 10 mg), may repeat once after 2 hours if needed (max 40 mg/24h)
    - **Rizatriptan**: 5 mg PO (for ages 6–17 years, weight-based), may repeat once after 2 hours (max 10 mg/24h)

**Note:** Avoid opioid and barbiturate-containing medications.

### b. **Preventive (Prophylactic) Treatment**

Consider if:
- ≥4 disabling headaches/month
- Significant impact on quality of life
- Poor response to acute therapy

**Options:**
- **Propranolol**: 10–20 mg PO BID, titrate as needed (max 2–4 mg/kg/day)
- **Amitriptyline**: 0.25–1 mg/kg PO at bedtime
- **Topiramate**: 25 mg PO at bedtime, titrate up to 100 mg/day as tolerated

**Selection based on comorbidities, side effect profile, and patient/family preference.**

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## 4. Non-Pharmacological Interventions

- **Lifestyle modifications:**
    - Regular sleep schedule
    - Hydration (adequate fluid intake)
    - Regular meals, avoid skipping meals
    - Limit caffeine and screen time
    - Regular physical activity
- **Trigger identification and avoidance:** Keep a headache diary
- **Stress management:** Relaxation techniques, cognitive-behavioral therapy (CBT) if indicated
- **Biofeedback** (if available)
- **Education** on early recognition and management of symptoms

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## 5. Follow-up Schedule

- **Initial follow-up:** 2–4 weeks after starting treatment or sooner if symptoms worsen
- **Subsequent follow-ups:** Every 3 months if stable, or as clinically indicated
- **Headache diary review** at each visit

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## 6. Monitoring Parameters

- **Headache frequency, severity, and duration** (headache diary)
- **Medication use:** Frequency and response to abortive therapy
- **Side effects** of medications (e.g., drowsiness, weight changes, mood changes)
- **Impact on daily activities** (school attendance, participation in activities)
- **Vital signs** (especially if on beta-blockers)
- **Growth parameters** (height, weight, BMI)

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## 7. Patient Education Points

- **Nature of migraine:** Not dangerous, but can be disabling
- **Importance of early treatment:** Take medication at onset of headache for best effect
- **Avoid medication overuse:** Limit acute medications to ≤2–3 days/week to prevent rebound headaches
- **Lifestyle factors:** Emphasize regular routines and trigger avoidance
- **When to seek urgent care:** If headache is sudden/severe, associated with fever, neck stiffness, confusion, weakness, vision loss, or persistent vomiting

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## 8. Potential Complications to Watch For

- **Medication overuse headache** (rebound headache)
- **Adverse effects** of medications (GI upset, sedation, mood changes, weight gain/loss, cognitive effects)
- **Progression to chronic migraine**
- **Psychosocial impact:** School absenteeism, anxiety, depression
- **Development of new or atypical symptoms** (may indicate secondary cause)

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**Note:**  
This plan should be individualized based on the patient’s full history, comorbidities, and response to therapy. All medication dosages should be confirmed and adjusted as appropriate for age and weight. **Consultation with a pediatric neurologist** is recommended for refractory or complex cases.

**Always advise close follow-up and re-evaluation if symptoms change or do not improve.**