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Current Neurology and Neuroscience Reports
Published in: Current Neurology and Neuroscience Reports 8/2021

01-08-2021 | Migraine | Headache (R.B. Halker Singh and J. VanderPluym, Section Editors)

Approach to Pediatric Intractable Migraine

Authors: Mohammed Alqahtani, Rebecca Barmherzig, Ana Marissa Lagman-Bartolome

Published in: Current Neurology and Neuroscience Reports | Issue 8/2021

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Abstract

Purpose of Review

Intractable migraine in children and adolescents is a significant cause of disability and decreased quality of life (QoL) in this population. Challenges include lack of unifying definition for intractable migraine, and limited data on best-practice management in this age group, with most current treatment pathways extrapolated from adult studies or expert consensus.

Recent Findings

A comprehensive approach in the evaluation and management of intractable migraine in this age group encompasses excluding secondary causes of headache; making an accurate diagnosis; identifying and appropriately managing modifiable risk factors; and initiating appropriate pharmacologic therapy to reduce disability, improve health-related quality of life, reduce risk of progression, and develop adaptive pain coping strategies. Several strategies for management of pediatric intractable migraine including use of acute medications, bridge therapy in outpatient setting, emerging therapies for preventive therapy, and a stepwise combination therapy for management of pediatric intractable migraine in emergency and inpatient setting are presented based on available clinical data, safety/tolerability, availability, cost-effectiveness, and expert consensus.

Summary

This descriptive review of the available literature focuses on approach to therapy for acute intractable migraine in a pediatric population including outpatient, emergency department (ED), and inpatient management.
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Metadata
Title
Approach to Pediatric Intractable Migraine
Authors
Mohammed Alqahtani
Rebecca Barmherzig
Ana Marissa Lagman-Bartolome
Publication date
01-08-2021
Publisher
Springer US
Keywords
Migraine
Headache
Published in
Current Neurology and Neuroscience Reports / Issue 8/2021
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-021-01128-9

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