11 Interesting Facts of Migraine in children
- Migraines are recurrent, episodic headache attacks that may or may not be preceded by a focal neurologic symptom (aura)
- Childhood periodic syndromes include cyclic vomiting, abdominal migraine, and benign paroxysmal vertigo of childhood
- History and physical examination, including neurologic examination, are the primary diagnostic methods
- Neuroimaging and laboratory tests are generally only necessary to help explore differential diagnoses for patients with headache and unexplained abnormal findings on neurologic examination
- 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
- Acute (abortive) therapy includes analgesics (eg, NSAIDs, acetaminophen) and triptans (in adolescents) 1
- 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
- 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
- Comorbidities frequently associated with migraine include depression, anxiety, epilepsy, and stroke
- Complications include chronic migraine, status migrainosus, and medication overuse headache
- Prognosis varies; migraine is a leading cause of disability
