Migraine in children

11 Interesting Facts of Migraine in children

  1. Migraines are recurrent, episodic headache attacks that may or may not be preceded by a focal neurologic symptom (aura)
  2. Childhood periodic syndromes include cyclic vomiting, abdominal migraine, and benign paroxysmal vertigo of childhood
  3. History and physical examination, including neurologic examination, are the primary diagnostic methods
  4. Neuroimaging and laboratory tests are generally only necessary to help explore differential diagnoses for patients with headache and unexplained abnormal findings on neurologic examination
  5. Therapy involves either treatment of acute headache or prevention of subsequent migraine. No medication is curative; encourage lifestyle modification and nondrug therapy to reduce the recurrence of migraine
  6. Acute (abortive) therapy includes analgesics (eg, NSAIDs, acetaminophen) and triptans (in adolescents) 1
  7. Preventive therapy (ie, antiepileptics, tricyclic antidepressants) is typically indicated when headaches occur more than once per week or are disabling (eg, child misses school, home, or social activities); also may be considered for cyclic vomiting
  8. Acknowledging the limitations of currently available evidence, clinicians should engage in shared decision-making regarding the use of short-term treatment trials (a minimum of 2 months) for those who could benefit from preventive treatment 2
  9. Comorbidities frequently associated with migraine include depression, anxiety, epilepsy, and stroke
  10. Complications include chronic migraine, status migrainosus, and medication overuse headache
  11. Prognosis varies; migraine is a leading cause of disability

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