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Published on: June 2, 2014
Migraine in children and adolescents
1Paediatric Neurosciences Unit, Royal Hospital for Children, Glasgow, UK.
Insights
Migraine in children and adolescents involves complex genetics and varied symptoms, including related childhood migraine syndromes. Advances offer targeted treatments, but clinical assessment remains key due to a lack of biomarkers.
Area of Science:
- Neurology
- Pediatrics
- Genetics
Background:
- Migraine is a complex neurological disorder with a polygenic aetiology.
- Its presentation is influenced by intrinsic and extrinsic factors.
- Childhood migraine encompasses various related disorders.
Purpose of the Study:
- To review recent advances in migraine research.
- To focus on the aetiology, pathogenesis, and clinical presentation in children and adolescents.
- To explore potential new mechanism-based treatments.
Main Methods:
- Narrative review of current literature.
- Emphasis on genetic and pathophysiological studies.
- Analysis of clinical presentations and treatment strategies.
Main Results:
- Migraine pathophysiology involves multiple neurotransmitters.
- New targeted treatments for acute episodes and prevention are emerging.
- Clinical assessment is crucial for diagnosis in the absence of biomarkers.
Conclusions:
- Understanding migraine complexity reveals the need for personalized treatment approaches.
- No single medication will suit all patients.
- Further research into specific mechanisms is essential for effective management.
Abstract:
This narrative review explores recent advances in the study of migraine with an emphasis on its complex polygenic aetiology, pathogenesis, clinical presentation, and the potential for new specific mechanism-based treatments in children and adolescents. The polygenic aetiology and complex pathogenesis of migraine make its clinical presentation subject to the influences of intrinsic physiological and psychological factors as well as extrinsic environmental and lifestyle factors. In addition to variation in the clinical presentation of migraine in children, several disorders, such as abdominal migraine, cyclical vomiting syndrome, benign paroxysmal vertigo, benign paroxysmal torticollis, and infantile colic, are considered under the wide umbrella of childhood migraine syndrome. Advances in the study of migraine pathophysiology have identified the important roles of several neurotransmitters and opened the way for the development of new specific medication to treat migraine episodes and for prevention. In the absence of reliable biomarkers, clinical assessment remains the backbone for the diagnosis and assessment of migraine. With better understanding of the complexity of migraine pathophysiology comes the realization that no single drug will solve all the problems of the disease for all patients.
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