Current approaches to the diagnosis and management of paediatric migraine

Headache is a common complaint in childhood with up to 75% of children reporting a notable headache by the age of 15 years. Paediatric migraine is the most frequent recurrent headache, occurring in up to 28% of older teenagers. Migraine can have a substantial effect on the life of the child, as well as their family, leading to lost school days and withdrawal from social interactions. Early recognition can lead to successful treatment, improved outcome, and reduced disability. The treatment strategy needs to be multipronged and can include acute therapy (which can vary depending on the severity of the headache), preventive therapy (when the headaches are frequent or causing substantial disability), and biobehavioural therapy (to assist with coping with recurrent headaches). Additional factors can contribute to exacerbations of headaches, including comorbid disorders and pubertal changes, which might lead to the development of menstrual migraine. When all these factors are effectively managed, there should be an improvement in long-term outcome and prevention of disease progression.