Prothrombotic risk factors in childhood migraine and comparison of acetylsalicyclic acid and propranolol in prophylactic therapy

Abstract

We aimed to investigate whether prothrombotic risk factors are more common in pediatric patients suffering from migraine than in the general population and compare the efficacy of prophylactic treatment with acetylsalicyclic acid (i.e., aspirin) and propranolol to ascertain whether acetylsalicyclic acid has additional efficacy over propranolol in migraine patients because of its antiplatelet property. Twenty-eight children aged 6 years through 16 years old affected by migraine with and without aura were included in the study. Factor V Leiden mutations, prothrombin 20210 mutations and factor VIII, factor IX, von Willebrand factor, antithrombin III, fibrinogen, homocysteine and lipoprotein A levels were determined. With the exception of antithrombin III deficiency, there was no increased prothrombotic risk factor in our migraine patients as compared to controls. Propranolol was clearly superior to acetylsalicyclic acid in decreasing the number of attacks. The duration and severity of headaches were also decreased in the propranolol group but this was not statistically significant. Therefore, we conclude that if there is no family history of stroke and/or if the patient does not have complicated migraine, routine investigation for prothrombotic risk factors is not indicated in children with migraine. Propranolol can be recommended as a first line drug for the prophylaxis of childhood migraine.