A 9-Year-Old Patient Has Been Diagnosed with Migraines for Almost

A 9-year-old patient has been diagnosed with migraines for almost two years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month. Which of the following would be appropriate?

A) Prescribe amitriptyline (Elavil) daily. Start at a low dose and increase dosage slowly every two weeks until it's effective in eliminating migraines.
B) Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache.
C) Prescribe propranolol (Inderal) to be taken daily for at least three months.
D) Explain that it is rare for a 9-year-old child to get migraines and she needs magnetic resonance imaging (MRI) to rule out a brain tumor.