Management of Pediatric Migraine in a Tertiary Care Versus Community Based Emergency Department: An Observational Pilot Study

Predictors of First‐Line Treatment Success in Children and Adolescents Visiting an Infusion Center for Acute Migraine

“…Some studies have described trends in visits to the pediatric ED for headache or have characterized the population of pediatric patients visiting acute settings with migraine beyond basic demographics such as age and sex. Few of these studies have used the International Classification of Headache Disorders criteria (ICHD), the accepted gold standard for migraine diagnosis, to ascertain migraine cases . There is an opportunity to better characterize this patient population using data from the infusion center setting, as case ascertainment in this setting is likely to be more accurate than in the ED.…”

“…In addition, few prospective studies on pediatric migraine in the ED have been carried out and this patient population remains poorly characterized. Some studies have described trends in visits to the pediatric ED for headache [7][8][9] or have characterized the population of pediatric patients visiting acute settings with migraine [10][11][12][13] beyond basic demographics such as age and sex. Few of these studies have used the International Classification of Headache Disorders criteria (ICHD), 14 the accepted gold standard for migraine diagnosis, to ascertain migraine cases.…”

“…Few of these studies have used the International Classification of Headache Disorders criteria (ICHD), 14 the accepted gold standard for migraine diagnosis, to ascertain migraine cases. 12,13 There is an opportunity to better characterize this patient population using data from the infusion center setting, as case ascertainment in this setting is likely to be more accurate than in the ED.…”

Acute Treatment Therapies for Pediatric Migraine: A Qualitative Systematic Review

“…Headache is a common reason for pediatric patients to present to the emergency department (ED), with national estimates of 250,000 visits occurring annually. 1 At the time of ED presentation, most pediatric headaches have been ongoing for 2-3 days, [2][3][4] and most patients have already used more than one abortive therapy. 2,5 Headaches are also costly, with an average total cost of adult patient ED visits estimated at $900 (U.S.).…”

“…Much of the current practice for emergency room treatment of pediatric headache is, therefore, based on adult trials or trials performed in non-ED settings. There is also variation in pediatric acute migraine management across institutions, 2,4,7 and evidence-based treatment is not always administered. A retrospective, observational study across four states found that close to half (46%) of pediatric patients presenting with migraine are not prescribed or recommended medication, while a much larger percentage (84%) are not prescribed or recommended evidence-based medication.…”