The spectrum of indomethacin-responsive headaches in children and adolescents

Area of Science:

• Neurology
• Pediatrics
• Pharmacology

Background:

• Headaches responding specifically to indomethacin are observed in children, but their full range of symptoms is not well understood.
• The phenotypic spectrum of indomethacin-responsive headaches in pediatric populations requires further investigation.

Purpose of the Study:

• To investigate the characteristics and spectrum of headaches in pediatric patients that show a significant response to indomethacin.
• To document the types of headache syndromes that benefit from indomethacin treatment in children and adolescents.

Main Methods:

• A retrospective review of pediatric patients experiencing headaches with at least 80% improvement after indomethacin treatment.
• Data was collected from seven academic medical centers, including patient demographics and headache diagnoses.

Main Results:

• Thirty-two pediatric patients (16 female) were included, with a mean age of 10.9 years at headache onset.
• Diagnoses included hemicrania continua, paroxysmal hemicrania, primary stabbing headache, and others, with some syndromes previously thought to occur only in adults.
• Adverse events, primarily gastrointestinal, were reported in 13 patients and often managed with gastroprotective agents.

Conclusions:

• Indomethacin is a viable treatment for a range of pediatric headaches, including those typically diagnosed in adults.
• High incidence of adverse events necessitates co-administration of gastroprotective agents in pediatric patients treated with indomethacin.