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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Treatment of acute migraine in the pediatric population
Hope L O'Brien1, Marielle A Kabbouche, Andrew D Hershey
1Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 2015, Cincinnati, OH, 45229, USA, Hope.O'Brien@cchmc.org.
Insights
Early and aggressive treatment for pediatric migraine is effective, utilizing over-the-counter medications, NSAIDs, and triptans. Dihydroergotamine (DHE) is reserved for intractable cases, with antiemetics and lifestyle changes aiding management.
Area of Science:
- Neurology
- Pediatrics
- Pharmacology
Background:
- Migraine diagnosis in children and adolescents is rising.
- Effective management strategies are crucial for this population.
Purpose of the Study:
- To outline current treatment approaches for pediatric migraine.
- To emphasize early and aggressive intervention.
Main Methods:
- Review of current therapeutic options for pediatric migraine.
- Discussion of pharmacologic and non-pharmacologic management.
Main Results:
- Over-the-counter medications are effective for early treatment.
- NSAIDs for mild-to-severe cases; triptans for moderate-to-severe, unresponsive headaches.
- Dihydroergotamine (DHE) for intractable migraines; antiemetics for nausea/vomiting.
Conclusions:
- Aggressive, early treatment is recommended for pediatric migraine.
- A stepwise approach using NSAIDs, triptans, and DHE is effective.
- Non-pharmacologic strategies, including trigger avoidance and lifestyle modification, are vital.
Opinion Statement:
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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