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[Migraine. Various current concepts]
1Centro Neurológico para Niños y Adolescentes, Monterrey, Nuevo León, México.
Insights
Migraine is a common neurological disorder in children, often linked to inherited neurotransmission issues. Propranolol and flunarizine show promise in preventing childhood migraine headaches.
Area of Science:
- Neurology
- Pediatrics
- Genetics
Context:
- Migraine affects children with varying prevalence based on age.
- The pathophysiology of migraine is evolving from vascular theories to neurochemical imbalances.
- International Headache Society criteria aid in diagnosis.
Purpose:
- To review the epidemiology, pathophysiology, and treatment of pediatric migraine.
- To discuss current understanding of migraine mechanisms.
- To outline diagnostic criteria and therapeutic options.
Summary:
- Migraine prevalence in children varies by age group.
- Current research suggests an unstable inherited serotonergic neurotransmission underlies migraine.
- Treatment includes abortive and preventive strategies, with propranolol and flunarizine noted for efficacy.
Impact:
- Provides an overview of pediatric migraine for clinicians and researchers.
- Highlights the shift in understanding migraine pathophysiology.
- Offers insights into effective preventive treatments for childhood migraines.
Abstract:
Migraine is a common disorder in children with a prevalence of 2.5% under seven years of age, 5% in those between the ages of seven and puberty and in postpuberal females it may be as prevalent as 10%. It is transmitted as an autosomally dominant trait and is frequently caused by precipitating factors. The vascular theory which stated that the aura was due to an intracranial vessel constriction and that the headache was due to an extracranial vasodilation has now be questioned due to new clinical and experimental data. Recently it is believed to be due to an unstable inherited serotonigenic neurotransmission which favors an increase in the frequency of neuronal discharge of the mid-brain raphe. Included is a classification and the diagnostic headache criteria used by the International Headache Society (1988). Treatment for migraine can be: a) abortive and b) preventive. Propranolol at a dosage of 2 mg/kg per day taken divided into three has shown to be the most beneficial in the prevention of migraine headaches. Certain calcium channel blockers, particularly flunarizine seem to have prophylactic value.