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Published on: June 2, 2014
Treatment of primary headache in children: a multicenter hospital-based study in France
Jean-Christophe Cuvellier1, Anne Donnet, Evelyne Guégan-Massardier
1Division of Paediatric Neurology, Department of Paediatrics, Lille Faculty of Medicine and Children's Hospital, Lille, France. jc-cuvellier@chru-lille.fr
Insights
This study found that specific headache treatments were underused in children and adolescents. Neuropediatric consultations led to more appropriate acute and prophylactic headache therapies, including non-steroidal anti-inflammatory drugs and psychotherapy.
Area of Science:
- Neurology
- Pediatrics
- Clinical Pharmacology
Background:
- Primary headaches are common in children and adolescents.
- Effective treatment strategies are crucial for managing pediatric headache disorders.
- Current treatment practices in neuropediatric settings require evaluation.
Purpose of the Study:
- To assess headache treatment patterns in children and adolescents before and after neuropediatric consultation.
- To identify underutilized specific treatments for primary headaches in a pediatric population.
- To compare treatment approaches based on headache diagnosis.
Main Methods:
- A 6-month prospective, multicenter study involving 398 children and adolescents with primary headaches.
- Data collection on prescribed acute and prophylactic headache treatments.
- Comparison of treatment strategies pre- and post-neuropediatric consultation.
Main Results:
- Paracetamol and non-steroidal anti-inflammatory drugs were the most frequent acute treatments pre-consultation.
- Post-consultation, paracetamol use decreased, with increased non-steroidal anti-inflammatory drugs and triptan prescriptions.
- Prophylactic treatment prescriptions nearly doubled, with significant increases in psychotherapy and relaxation training.
Conclusions:
- Specific treatments for primary headaches in children and adolescents were underused.
- Neuropediatric consultations improved the appropriateness of acute and prophylactic headache management.
- Further optimization of treatment protocols in pediatric headache care is warranted.
Abstract:
The aim of this 6-month, prospective, multicenter study of 398 children and adolescents with primary headaches was to collect data on headache treatment in neuropediatric departments. Treatments were compared before and after consultation. Prior to consultation, the acute treatments that had been prescribed most frequently were paracetamol (82.2% of children) and non-steroidal anti-inflammatory drugs treatment (53.5%); 10.3% had received a prophylactic treatment. No differences in either acute or prophylactic treatment with respect to headache diagnosis were observed. After the neuropediatric consultation, paracetamol was replaced by a non-steroidal anti-inflammatory drug in about three-quarters of cases and by triptan in about one-quarter of cases. The number of children prescribed a prophylactic treatment nearly doubled, whereas there was a 5-fold and 23-fold increase in psychotherapy and relaxation training, respectively, between pre-referral and referral. We conclude that specific treatments were underused for primary headache.
