Abstract
Migraine is the most common cause of acute recurrent headaches in children. The pathophysiological concepts have evolved from a purely vascular etiology to a neuroinflammatory process. Clinical evaluation is the mainstay of diagnosis and should also include family history. Investigations help to rule out secondary causes. The role of new drugs in treatment of migraine is discussed and trials are quoted from literature. Indications for starting prophylaxis should be evaluated based on frequency of attacks and influence on quality of life. For management of acute attacks of migraine both acetaminophen and ibuprofen are recommended for use in children. Many drugs like antiepileptic drugs (AED), calcium channel blockers, and antidepressants have been used for prophylaxis of migraine in children. The data for use of newer drugs for migraine in children is limited, though AEDs are emerging a popular choice. Biofeedback and other nonmedicinal therapies are being used with promising results.
Highlights
Headache is a disabling neurological disorder of varied etiologies and a frequent health problem in children and adolescents [1]
Chronic recurrent headaches occur in approximately 40% of children at age of seven, increasing to 75% by the age of fifteen years
A detailed neurologic examination is essential to look for any objective evidence of organic causes of recurrent headaches
Summary
Headache is a disabling neurological disorder of varied etiologies and a frequent health problem in children and adolescents [1]. Headaches in children can be a primary disorder or secondary to a number of causes. Secondary headaches include conditions related to intracranial and extracranial infections, intracranial mass lesions, and head and neck trauma. Prepubertal boys are more affected than girls, but after puberty, headaches are more common in girls [3]. Migraine is the most common cause and accounts for more than half the cases of recurrent headaches in children [4]. With such a high prevalence in school-aged children, migraine has significant effect on school attendance and family dynamics involved in caring for a sick child, with loss of job productivity and work attendance in parents [5]
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