Managing Migraine Headaches in Children and Adolescents

SUMMARY

The diagnosis and management of migraine headaches can be challenging in children and adolescents. The description of migraine in this population may include symptoms that are not typically described in adults. Treatment options for pediatric migraine is increasing, however remain limited. This article will go through the key components to diagnosing migraine in pediatric patients as well as give options for short and long-term management.

KEYWORDS:

• Migraine
• headache
• children
• adolescents
• acute treatment
• prevention
• nutraceuticals

Financial & competing interests disclosure

H O’Brien is a part of the Labry Pharmaceuticals Research Clinical Trial. M Kabbouche is a part of the CHAMP Research Clinical Trial for NIH and Chronic Migraine Research Study for Allergan. A Hershey is receiving consulting fees for the following companies Allergan, Amgen, and Lilly. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Migraine is common in children and adolescents.

• Correct diagnosis of pediatric migraine is important to proper management.

• NSAIDs and over-the-counter analgesics continue to remain first-line options for acute migraine.

• There have been several triptans including almotriptan, rizatriptan, sumatriptan/naproxen sodium and intranasal zolmitriptan that have been US FDA approved for intractable migraine.

• Topiramate is the only US FDA-approved medication for pediatric migraine preventative.

• Biobehavioral management and lifestyle modification should be included in the migraine treatment plan.

• Future studies are needed as treatment options remain limited in this population.