Predicting quality of life outcomes in children with migraine

ABSTRACT

Introduction

Several studies have shown that the response of children with migraine to medications is suboptimum and inferior to the response reported in adults, despite the similar pathogenesis and biological mechanisms. The poor response may be related to the significant differences that make assessment and treatment of children with migraine more challenging than in adults.

Areas covered

The purpose of this review is to discuss the whole process of assessment of children with migraine, the necessary skills for eliciting the clinical features, making the correct diagnosis and exploring lifestyle issues, co-morbid conditions (psychological and physical) and social influences on disease presentations. Also, to establish and address peculiarities of migraine in children that would enable clinicians to advise on lifestyle modifications, co-morbid conditions and the correct choice of treatment options including non-pharmacologic therapies and medications.

Expert opinion

The choice of treatment should be based on an assessment of each individual child taking into account, age, gender, pubertal status, body weight, comorbid disorders and family history. Also considering the profile of migraine episodes, frequency, duration, associated symptoms and effects of nausea and vomiting. Using the appropriate medications in appropriate dosage, formulation and route and timing of administration may improve adherence to treatment and outcome.

KEYWORDS:

• adolescents
• children
• lifestyle modification
• migraine
• migraine assessment
• migraine impact
• outcome predictors
• treatment outcome
• quality of life

Article highlights

• Migraine is a common disorder in children and adolescents with a prevalence of 7.7% worldwide

• Migraine has a significant impact on child’s quality of life.

• Successful treatment relies on making correct diagnosis, assessment of the psychosocial influences and comorbidities.

• Lifestyle factors influence response to treatment and should be addressed and managed

• Success of treatment is dependent on the knowledge, attitude and confidence of the child and family in the assessment process and decision making

• Achieving treatment targets leads to a better quality of life outcomes in susceptible children

Declaration of interests

I Abu-Arafeh is chair of the Child and Adolescent committee, the International Headache Society 2013–2021, and received consultancy fees from Lundbeck and Amgen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.