Effectiveness of Nonpharmacologic Treatment for Migraine in Young Children

Eidlitz‐Markus, Tal; Haimi-Cohen, Yishai; Steier, David; Zeharia, Avraham

doi:10.1111/j.1526-4610.2009.01534.x

Cited by 37 publications

(34 citation statements)

References 23 publications

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“…& In counseling children and parents about migraine treatment, one needs to discuss the importance of incorporating healthy habits, which include adequate sleep, staying well hydrated, routine daily exercise, and a well-balanced diet without skipping meals [5]. This approach should be applied to all patients with migraine and can frequently minimize the impact of the migraine on a child's life, while reducing the need for pharmacologic agents.…”

Section: Diet and Lifestylementioning

confidence: 97%

Treatment of Acute Migraine in the Pediatric Population

O’Brien

Kabbouche

Hershey

2010

Curr Treat Options Neurol

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The recognition of the diagnosis of migraine in the pediatric population is increasing. Early and aggressive treatment of migraine in children and adolescents with the use of over-the-counter medications has proven effective. In addition, the off-label use of many migraine-specific medications is often accepted in the absence of sufficient evidence-based trials. Mild to severe cases of migraine should be treated with NSAIDs, with triptans used for moderate to severe headaches that are unresponsive to over-the-counter therapy. Rescue medication including dihydroergotamine (DHE) should be used for intractable migraines, preferably in the hospital setting. In patients with associated symptoms of nausea and vomiting, antiemetics with antidopaminergic properties can be helpful through their action on central migraine generation. Furthermore, patients and families should be educated about nonpharmacologic aspects of management such as preventing episodic migraine through lifestyle modification and avoidance of triggers.

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Section: Diet and Lifestylementioning

confidence: 97%

Treatment of Acute Migraine in the Pediatric Population

O’Brien

Kabbouche

Hershey

2010

Curr Treat Options Neurol

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“…Lifestyle modifications are often discussed with patients, including maintenance of good sleep hygiene, a well balanced diet, sufficient daily hydration and regular exercise [50]. Good sleep hygiene is often defined as regular bedtimes and waking times with sufficient sleep time.…”

Section: Behavioral Measuresmentioning

confidence: 99%

Prophylaxis of Migraine in Children and Adolescents

Kacperski

2015

Pediatr Drugs

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While it has been established that headaches in the pediatric age group are relatively common, the characterization of headache disorders and their treatment in this group has historically been limited. Due to the paucity of controlled studies on prophylaxis of the primary headache disorders in children, the diagnosis of migraine often rests on criteria similar to those used in adults. Data from adult studies are often extrapolated and applied to the pediatric patient. Although it appears that many prophylactic agents are safe, well tolerated and efficacious in children, currently only topiramate is FDA-approved for use in patients 12 years and over. As a result, despite often experiencing significant disability, many children who present to their physician with migraines do not receive preventive therapy. One-third of adolescents meet the criteria for warranting prophylactic therapy, yet few are offered a preventative medication. Moreover, controlled clinical trials investigating the use of both abortive and prophylactic medications in children have suffered from high placebo response rates. A diverse group of medications are used to prevent migraine attacks, including antidepressants, antiepileptics, antihistamines and antihypertensive agents, yet there still remains a serious lack of controlled studies on the pharmacological treatment of pediatric migraine.

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“…Bruni and colleagues reported a reduction in mean duration and frequency of headaches in 70 children who were carefully instructed on appropriate sleep hygiene and were compared with 94 children who were not [Bruni et al 1999]. Regarding dietary restrictions, the American Headache Society only recommends limiting caffeine intake and does not restrict any type of food unless a very specific food trigger is identified [Eidlitz-Markus et al 2010]. A balanced diet, nonetheless, appears to be important and skipping meals is often identified as a trigger.…”

Section: Behavioral Measuresmentioning

confidence: 99%

“…Lifestyle modifications are often discussed with patients, including maintenance of good sleep hygiene, a well-balanced diet, sufficient hydration, and regular exercise [Eidlitz-Markus et al 2010]. Bruni and colleagues reported a reduction in mean duration and frequency of headaches in 70 children who were carefully instructed on appropriate sleep hygiene and were compared with 94 children who were not [Bruni et al 1999].…”

Section: Behavioral Measuresmentioning

confidence: 99%

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The optimal management of headaches in children and adolescents

Kacperski

Kabbouche

O’Brien

et al. 2015

Ther Adv Neurol Disord

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The recognition of the diagnosis of migraine in children is increasing. Early and aggressive treatment of migraine in this population with the use of over-the-counter medications has proven effective. The off-label use of many migraine-specific medications is often accepted in the absence of sufficient evidenced-based trials. Mild to severe cases of migraine should be treated with nonsteroidal anti-inflammatory drugs, with triptans used in moderate to severe headaches unresponsive to over-the-counter therapy. Rescue medication including dihydroergotamine [DHE] should be used for status migrainosus, preferably in the hospital setting. Antiemetics that have antidopaminergic properties can be helpful in patients with associated symptoms of nausea and vomiting through their action on central migraine generation. Furthermore, patients and families should be educated on nonpharmacologic management such as lifestyle modification and avoidance of triggers that can prevent episodic migraine.

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Effectiveness of Nonpharmacologic Treatment for Migraine in Young Children

Abstract: As the primary option, conservative therapy for migraine appears to be more effective in children younger than 6 years than in older children, perhaps because of their shorter duration of disease until treatment and lower frequency of attacks.

Cited by 37 publications

References 23 publications

Treatment of Acute Migraine in the Pediatric Population

Treatment of Acute Migraine in the Pediatric Population

Prophylaxis of Migraine in Children and Adolescents

The optimal management of headaches in children and adolescents

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