Migraine is common in children and is one of the most common etiologies of headache leading to emergency room presentation in children. Despite this, few studies have investigated the treatment of acute migraine headache in the emergency room. We propose a prospective, double-blind, placebo-controlled, cross-over study of metoclopramide versus placebo in the treatment of acute migraine headache with open-label rescue using valproic acid. The primary outcome will be the number of patients who are pain free at two hours. The use of a standardized rescue medication will provide exploratory data for possible future trials. Clinical experience is that many children do not experience headache relief with first line medications such as metoclopramide or experience rapid recurrence of headache. Prior data has demonstrated that many children with headache have co-morbid anxiety, depression or other psychological co-morbidities. There has been little investigation of these psychological co-morbidities in children with migraine headache although clinical experience and limited investigations suggest that when these co-morbidities are addressed some children with refractory headache improve. We prose a descriptive study of these co-morbidities in children presenting with acute migraine, and a comparison of medication efficacy among children with and without psychological co-morbidity.