Migraine in childhood

Index

Acute Treatment of Migraine in Pediatrics: Guidelines and Recommendations

Guidelines Overview

• Published By: American Headache Society and American Academy of Neurology (Oskui M et al., 2019A; 2019B)
• Year: 2019
• Focus Areas:
  • Prompt treatment
  • Migraine characteristics and associated symptoms
  • Medication formulation
  • Incorporation of healthy lifestyle habits

  Importance of Acute Treatment

  • Risks of Ineffective Treatment:
    • Medication overuse headache
    • Progression to chronic migraine

    Medication and Treatment Options

    • Correct headache diagnosis
    • Diagnostic testing for secondary headache disorders
    • Assessment of premonitory/aura symptoms, headache features, associated symptoms, and overall disability
    • Goal: Quick-acting, effective therapy with minimal side effects

    Counseling and Early Intervention

    • Triptans:
      • Most effective for pain relief
      • Less effect on associated nausea and vomiting

      Considerations for Triptan Selection

      • Limited clinical trials for migraine-associated nausea
      • Demonstrated safety in pediatric gastroenteritis
      • Recommended for significant nausea or vomiting

      Patient and Family Education

      • Over-the-Counter Medications:
        • Acetaminophen, ibuprofen, naproxen
        • Weight-based doses

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