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The Changing Landscape of Pediatric Migraine Therapy: A Review
Carlyn Patterson-Gentile1, Christina L Szperka1,2
1Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Importance:
Migraine is a disabling and prevalent condition that affects the pediatric and adolescent population. This review describes current acute and preventive migraine pharmacologic therapies for the pediatric and adolescent population.
Observations:
Multiple pharmacotherapies that have been used in the treatment of acute headache and prevention in pediatric migraine are reviewed. There have been recent advances in the management of migraines among pediatric and adolescent patients, including US Food and Drug Administration approval of triptans for acute management in children as young as 6 years, and the first prospective, randomized, double-blind, placebo-controlled comparative study of preventive pharmacotherapy in pediatric migraine. A major challenge of evidence-based research in pediatric and adolescent migraine is the significant placebo effect.
Conclusions And Relevance:
Although progress is being made in the management of migraines among pediatric and adolescent patients, there remains much work to be done.
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Work Done During Volume Change
Consider a gas confined to a cylinder fitted with a movable piston at one end. If the gas expands from volume V1 to volume V2, it exerts a force on the piston, such that the piston moves by a distance dr.
The work done by the gas on the piston can be expressed as
Net Change Theorem

