What is the first-line treatment for acute migraine in children?

The first-line treatment for acute migraine in children is indeed NSAIDs (non-steroidal anti-inflammatory drugs). This is because NSAIDs are effective in alleviating pain and reducing inflammation, which are both crucial in managing acute migraine attacks. In pediatric patients, these medications can provide significant relief from headache symptoms and are generally well-tolerated.

NSAIDs like ibuprofen and naproxen are commonly recommended due to their accessibility and favorable side effect profile compared to other classes of medications. They work by inhibiting the cyclooxygenase (COX) enzyme, thus decreasing the production of prostaglandins that mediate pain and inflammation.

In the context of treating acute migraine, NSAIDs have been shown to be safe and effective, making them the preferred initial approach. Other treatments may be considered if NSAIDs are ineffective or contraindicated, but they do not have the same established first-line status in the pediatric population. For example, antidepressants, opioids, and corticosteroids are not standard treatments for acute migraine; instead, they serve different roles in pain management or in chronic migraine prevention.