My 13-year-old has had a nonstop migrain

Call her pediatrician's office today and ask for an urgent appointment, and if the first slot offered is days away, ask for a same-day or urgent-clinic slot — a headache that has run for weeks, is not being stopped by the usual rescue medicine, and is now costing school days is a same-week review, not a routine check-up.

What to say to the receptionist, so the urgency lands in one line: "She's 13, the headache has been nearly continuous for several weeks, the usual rescue medicine isn't working, and she's missing school. I'd like an urgent appointment, and if that's far off, an urgent-clinic slot or a cancellation list."

Nothing on this page is a diagnosis, and no medicine is being started, stopped or changed here. Every medicine decision stays with her prescriber.

1. What you've tried, and what usually goes alongside it

The dark quiet room is not the wrong thing — it is one of the standard things, and the NHS patient page for migraine lists it too. What usually gets built around it is the boring half: a fixed wake-up time even on days she misses school, food and drink offered rather than remembered, screens cut during an attack, caffeine kept steady rather than increased, and something gentle and optional to do if moving helps.

Keep the setup under about 25 minutes, most of it in the evening:

• water and one normal snack on a tray by the bed — 5 minutes
• decide the wake-up time once and write it in one visible place — 2 minutes
• fill today's diary line, one row, while the day is fresh — 5 minutes
• a quiet corner of the house agreed as her low-light spot for school days — 10 minutes

The headache diary you already keep is the most valuable thing in the house right now, and it is what decides whether this needs a scan or a plan. What a specialist reads in it is the shape, not the prose: date and time it started, one side or both, throbbing or band-like, worst 0–10, whether light, noise, water, being alone, sleep or exercise made it worse, what was taken and when, and whether it helped. One line per day, including the days she felt fine, is plenty.

What a pediatric headache appointment can actually be for, so you can aim the request at it: a review of the diary and a physical examination; a decision about whether anything secondary is being ruled out; a written plan for what to do at the start of an attack, in the medicines her prescriber has already chosen; a preventive option to discuss; non-drug options such as relaxation techniques or CBT; a school plan; and a referral to a pediatric headache specialist if the first steps don't work. The NHS page notes that if simple measures don't help or things get worse, referral for further assessment is normal, and that most children's headaches need no tests unless warning signs are present (checked 5 October 2026). Which preventive, if any, is hers to decide with her prescriber — not something to shop for in advance.

2. The avoid list

• No extra tablet, no doubling, no stacking two boxes — read the box in your hand for the same ingredient.
• No borrowed migraine tablet, no opioid, nothing bought online, no powders or herbal mixes.
• Don't cut the prescribed rescue medicine short or add a "day off" rule of your own. How many days out of the last 30 she used it is one of the most important facts on the sheet, and the limit is the clinician's to set. Official patient guidance also notes that using painkillers too often can itself make headaches harder to treat.
• No skipped meals as a strategy, no caffeine increase, no "push through it" school day on a bad day.
• Don't promise the school a return date you don't control. Say what review is happening and what a bad day looks like.

3. Red flags — when to stop the home plan

Any one of these, and you call your local emergency number now and go to the nearest emergency department, do not wait for the appointment:

• the worst headache of her life, at full strength within seconds
• fever together with the headache, a stiff neck, drowsiness or confusion, or a rash that does not fade under a glass
• one side weak or numb, speech change, blurred or double vision, or a fit
• it wakes her from sleep, or she wakes with it and vomits, or coughing and bending make it much worse
• a red painful eye with rainbow rings around the lights
• more than one person in the house with headache and nausea — get everyone into fresh air and call
• getting sleepier or more confused after a knock to the head

One rule worth holding onto: a soft neck, or her looking quiet, does not rule any of these out, and a drowsy child with a fever is not to be put back to bed "to see how she is in the morning."

Decision tree

• Any red flag on the list above → local emergency number now, nearest emergency department.
• No red flag, and the headache is still nearly continuous or the usual relief is still not working → the urgent appointment you are requesting today. This is the branch you are in.
• No red flag, and she is brighter, the pain is lower, and she is eating, drinking and sleeping → keep the routine and the diary, add no medicine, keep the appointment, and write down anything that changes.

The school note, ready to copy

"Dear [teacher], [name] has had a continuous headache for several weeks that we are having reviewed by [clinic] — appointment [date]. Until the review, I am asking for [partial attendance on the days she is brighter / a quiet low-light room when she is in / prompt pickup when I message you]. I will update you after the appointment. Thank you."

What success looks like in the next 24 hours — none of it a promise the headache will lift:

• the urgent appointment is requested and you have a date, or a place on a cancellation list
• the diary has one line per day, including the good days
• the rescue-medicine box is in her bag with the strength visible on it
• the school note is sent
• you have named, out loud, the one change that would mean you go tonight

The general points about attacks, prevention, and referral above were checked against the NHS patient page on migraine on 5 October 2026.

Which country and city are you in? That decides whether the faster door is an urgent clinic, a same-day pediatric service, or a hospital emergency department, and how a referral to a pediatric headache specialist is arranged there — tell me the city and I will point you at the right one.