Migraine in children. Diagnostics features and modern possibilities of therapy
A.V. Sergeev1, E.V. Ekusheva2
1 Sechenov University, Moscow
2 Institution of Advanced Training of Federal Medical and Biological Agency, Moscow
Recurrent headaches (RH) are noted almost in every second child. About 10% of children suffer from migraine. At the same time, in the setting of RH overdiagnosis, migraine is diagnosed only in 20–30% of children. This review is intended for practical neurologists and is based on the latest evidences on the diagnosis and modern therapy of headaches in children and adolescents. Diagnosis of various forms of migraine should be carried out in accordance with the criteria and recommendations of the International Classification of Headache Disorders of the 3rd revision for children. The first diagnosis of migraine is based on the clinical data of the attack and the absence of any abnormalities in the neurological status. The use of adapted child visual analogue scales, questionnaires for assessing the intensity of pain and associated symptoms based on the child’s behavior, RH journaling effectively helps in the diagnosis and evaluation of indications for the choice of preventive therapy. Migraine treatment is a multidisciplinary task, sometimes requiring changes in the daily activity of the child, family and school relationships, and psychological support. Early treatment with analgesics is recommended for the symptomatic therapy of migraine, of which ibuprofen (Nurofen®) and paracetamol are the first choice drugs. In severe attacks, triptans (not registered in the Russian Federation for children use) and antiemetic drugs, as well as parenteral administration of drugs (in particular, valproic acid and magnesium sulfate), are possible.
Key words: migraine, tension-type headache, children, adolescents, treatment, ibuprofen, Nurofen®.
For citation: Sergeev A.V., Ekusheva E.V. Migraine in children. Diagnostics features and modern possibilities of therapy // RMJ. Medical Review. 2018. № 9. P. –32.
References
1. Victor T.W., Hu X., Campbell J.C. et al. Migraine prevalence by age and sex in the United States: a life-span study // Cephalalgia. 2010. Vol. 30. P. 1065–1072.
2. Elser J.M., Woody R.C. Migraine headache in the infant and young child // Headache 1990. Vol. 30. Р. 366–368.
3. Рачин А.П., Юдельсон Я.Б., Сергеев А.В. Эпидемиология хронической ежедневной головной боли у детей и подростков // Боль. 2004. №2(3). С. 27–30 [Rachin A.P., Yudel’son Ya.B., Sergeyev A.V. Epidemiologiya khronicheskoy yezhednevnoy golovnoy boli u detey i podrostkov // Bol’. 2004. №2(3). S. 27–30 (in Russian)].
4. Congdon P.J., Forsythe W.I. Migraine in childhood: a study of 300 children // Dev Med Child Neurol. 1979. Vol. 21. P. 209–216.
5. Lee L.H., Olness K.N. Clinical and demographic characteristics of migraine in urban children // Headache. 1997. Vol. 37. P. 269–276.
6. Lipton R.B., Manack A., Ricci J.A. et al. Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C-dAS) // Headache. 2011. Vol. 51. P. 693–706.
7. Sasmaz T., Bugdayci R., Ozge A. et al. Are parents aware of their schoolchildren’s headache? // Eur J Public Health. 2004. Vol. 14(4). P. 366–368.
8. Сергеев А.В. Мигрень и головная боль напряжения у детей // Вопросы современной педиатрии. 2012. T. 11(5). С. 64–69 [Sergeyev A.V. Migren’ i golovnaya bol’ napryazheniya u detey // Voprosy sovremennoy pediatrii. 2012. T. 11(5). S. 64–69 (in Russian)].
9. Chakravarty A., Mukherjee A., Roy D. Migraine pain location: how do children differ from adults? // J Headache Pain. 2008. Vol. 9(6). P. 375–379.
10. Powers S.W., Hershey A.D., Coffey C.S. et al. The childhood and adolescent migraine prevention (CHAMP) study: a report on baseline characteristics of participants // Headache. 2016. Vol. 56(5). P. 859–870.
11. Rossi L.N., Cortinovis I., Menegazzo L. et al. Behaviour during attacks and assessment of intensity in primary headaches of children and adolescents // Cephalalgia. 2006. Vol. 26(2). P. 107–112.
12. Özge A., Faedda N., Abu-Arafeh I. et al. Experts’ opinion about the primary headache diagnostic criteria of the ICHD-3rd edition beta in children and adolescents // J Headache Pain. 2017. Vol. 18(1). P. 109.
13. McAbbee G.N., Morse A.M., Assadi M. Pediatric aspects of headache classification in the international classification of headache disorders—3 (ICHD-3 beta version) // Curr Pain Headache Rep. 2016. Vol. 20. P. 7.
14. Gelfand A.A., Reider A.C., Goadsby P.J. Cranial autonomic symptoms in pediatric migraine are the rule, not the exception // Neurology. 2013. Vol. 81. P. 431–436.
15. Özge A., Sasmaz T., Cakmak S.E. et al. Epidemiological-based childhood headache natural history study: after an interval of six years // Cephalalgia. 2010. Vol. 30. P. 703–712.
16. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition // Cephalalgia. 2018. Vol. 33. P. 629–808.
17. Lewis D. Headaches in Children and Adolescents // Curr Probl Pediatr Adolesc Health Care. 2007. Vol. 37(6). P. 207–246.
18. Holroyd K., Mauskop A. Complementary and alternative treatments // Neurology 2003. Vol. 60 (Suppl. 2). P. 58–62.
19. Baumann R.J. Behavioral treatment of migraine in children and adolescents // Paediatr Drugs. 2002. Vol. 4(9). P. 555–561.
20. Fichtel A., Larsson B. Relaxation treatment administered by school nurses to adolescents with recurrent headache // Headache. 2004. Vol. 44. P. 545–554.
21. Eiland L.S., Hunt M.O. The use of triptans for pediatric migraines // Paediatr Drugs. 2010. Vol. 12. P. 379–389.
22. Lewis D., Kellstein D., Burke B. et al. Children’s ibuprofen suspension for the acute treatment of migraine headache // Headache. 2002. Vol. 42. P. 780–786.
23. Hamalainen M.L., Hoppu K., Valkeila E. et al. Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study // Neurology. 1997. Vol. 48. P. 102–107.
24. Lewis D., Ashwal S., Hershey A. et al. Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society // Neurology. 2004. Vol. 63. P. 2215–2224.
25. El-Chammas K., Keyes J., Thompson N. et al. Pharmacologic treatment of pediatric headaches: a meta-analysis // JAMA Pediatr. 2013. Vol. 167. P. 250–258.
26. O’Brien H.L., Kabbouche M.A., Hershey A.D. Treating pediatric migraine: an expert opinion // Expert Opin Pharmacother. 2012. Vol. 13. P. 959–966.
27. Agency for Healthcare Research and Quality. U.S. Department of Health and Human Services. Migraine in children: Preventive pharmacologic treatments. Comparative Effectiveness Review Number 108. June 2013. (Электронный источник). URL: http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproductandproductID=1515 (дата обращения: 26.10.2018).
28. Szperka C.L., VanderPluym J., Orr S.L. et al. Recommendations on the Use of Anti-CGRP Monoclonal Antibodies in Children and Adolescents // Headache. 2018. Oct 15. [Epub ahead of print]. DOI: 10.1111/head.13414.
29. Orr S.L., Venkateswaran S. Nutraceuticals in the prophylaxis of pediatric migraine: Evidence-based review and recommendations // Cephalalgia. 2014. Vol. 34. P. 568–583.
30. Termine C., Ozge A., Antonaci F. et al. Overview of diagnosis and management of paediatric headache. Part II: therapeutic management // J Headache Pain. 2011. Vol. 12(1). P. 25–34.
31. Ludvigsson J. Propranolol used in prophylaxis of migraine in children // Acta Neurol. 1974. Vol. 50. P. 109–115.
32. Lewis D., Diamond S., Scott D. Prophylactic treatment of pediatric migraine // Headache. 2004. Vol. 44. P. 230–237.
33. Guidetti V., Moscato D., Ottaviano S. et al. Flunarizine and migraine in childhood an evaluation of endocrine function // Cephalalgia. 1987. Vol. 7. P. 263–266.
34. Hershey A.D., Powers S.W., Bentti A.L., deGrauw T.J. Effectiveness of amitriptyline in the prophylactic management of childhood headaches // Headache. 2000. Vol. 40. P. 539–549.
35. Winner P., Pearlman E., Linder S. et al. Topiramate for migraine prevention in children: a randomized, double-blind, placebo-controlled trial // Headache. 2005. Vol. 45. P. 1304–1312.
36. Serdaroglu G., Erhan E., Tekgul H. et al. Sodium valproate prophylaxis in childhood migraine // Headache. 2002. Vol. 42. P. 819–822.
37. Miller G.S. Efficacy and safety of levetiracetam in pediatric migraine // Headache. 2004. Vol. 44. P. 238–243.
38. Belman A.L., Milazo M., Savatic M. Gabapentin for migraine prophylaxis in children // Ann Neurol. 2001. Vol. 50(Suppl. 1). P. S109.
2. Elser J.M., Woody R.C. Migraine headache in the infant and young child // Headache 1990. Vol. 30. Р. 366–368.
3. Рачин А.П., Юдельсон Я.Б., Сергеев А.В. Эпидемиология хронической ежедневной головной боли у детей и подростков // Боль. 2004. №2(3). С. 27–30 [Rachin A.P., Yudel’son Ya.B., Sergeyev A.V. Epidemiologiya khronicheskoy yezhednevnoy golovnoy boli u detey i podrostkov // Bol’. 2004. №2(3). S. 27–30 (in Russian)].
4. Congdon P.J., Forsythe W.I. Migraine in childhood: a study of 300 children // Dev Med Child Neurol. 1979. Vol. 21. P. 209–216.
5. Lee L.H., Olness K.N. Clinical and demographic characteristics of migraine in urban children // Headache. 1997. Vol. 37. P. 269–276.
6. Lipton R.B., Manack A., Ricci J.A. et al. Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C-dAS) // Headache. 2011. Vol. 51. P. 693–706.
7. Sasmaz T., Bugdayci R., Ozge A. et al. Are parents aware of their schoolchildren’s headache? // Eur J Public Health. 2004. Vol. 14(4). P. 366–368.
8. Сергеев А.В. Мигрень и головная боль напряжения у детей // Вопросы современной педиатрии. 2012. T. 11(5). С. 64–69 [Sergeyev A.V. Migren’ i golovnaya bol’ napryazheniya u detey // Voprosy sovremennoy pediatrii. 2012. T. 11(5). S. 64–69 (in Russian)].
9. Chakravarty A., Mukherjee A., Roy D. Migraine pain location: how do children differ from adults? // J Headache Pain. 2008. Vol. 9(6). P. 375–379.
10. Powers S.W., Hershey A.D., Coffey C.S. et al. The childhood and adolescent migraine prevention (CHAMP) study: a report on baseline characteristics of participants // Headache. 2016. Vol. 56(5). P. 859–870.
11. Rossi L.N., Cortinovis I., Menegazzo L. et al. Behaviour during attacks and assessment of intensity in primary headaches of children and adolescents // Cephalalgia. 2006. Vol. 26(2). P. 107–112.
12. Özge A., Faedda N., Abu-Arafeh I. et al. Experts’ opinion about the primary headache diagnostic criteria of the ICHD-3rd edition beta in children and adolescents // J Headache Pain. 2017. Vol. 18(1). P. 109.
13. McAbbee G.N., Morse A.M., Assadi M. Pediatric aspects of headache classification in the international classification of headache disorders—3 (ICHD-3 beta version) // Curr Pain Headache Rep. 2016. Vol. 20. P. 7.
14. Gelfand A.A., Reider A.C., Goadsby P.J. Cranial autonomic symptoms in pediatric migraine are the rule, not the exception // Neurology. 2013. Vol. 81. P. 431–436.
15. Özge A., Sasmaz T., Cakmak S.E. et al. Epidemiological-based childhood headache natural history study: after an interval of six years // Cephalalgia. 2010. Vol. 30. P. 703–712.
16. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition // Cephalalgia. 2018. Vol. 33. P. 629–808.
17. Lewis D. Headaches in Children and Adolescents // Curr Probl Pediatr Adolesc Health Care. 2007. Vol. 37(6). P. 207–246.
18. Holroyd K., Mauskop A. Complementary and alternative treatments // Neurology 2003. Vol. 60 (Suppl. 2). P. 58–62.
19. Baumann R.J. Behavioral treatment of migraine in children and adolescents // Paediatr Drugs. 2002. Vol. 4(9). P. 555–561.
20. Fichtel A., Larsson B. Relaxation treatment administered by school nurses to adolescents with recurrent headache // Headache. 2004. Vol. 44. P. 545–554.
21. Eiland L.S., Hunt M.O. The use of triptans for pediatric migraines // Paediatr Drugs. 2010. Vol. 12. P. 379–389.
22. Lewis D., Kellstein D., Burke B. et al. Children’s ibuprofen suspension for the acute treatment of migraine headache // Headache. 2002. Vol. 42. P. 780–786.
23. Hamalainen M.L., Hoppu K., Valkeila E. et al. Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study // Neurology. 1997. Vol. 48. P. 102–107.
24. Lewis D., Ashwal S., Hershey A. et al. Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society // Neurology. 2004. Vol. 63. P. 2215–2224.
25. El-Chammas K., Keyes J., Thompson N. et al. Pharmacologic treatment of pediatric headaches: a meta-analysis // JAMA Pediatr. 2013. Vol. 167. P. 250–258.
26. O’Brien H.L., Kabbouche M.A., Hershey A.D. Treating pediatric migraine: an expert opinion // Expert Opin Pharmacother. 2012. Vol. 13. P. 959–966.
27. Agency for Healthcare Research and Quality. U.S. Department of Health and Human Services. Migraine in children: Preventive pharmacologic treatments. Comparative Effectiveness Review Number 108. June 2013. (Электронный источник). URL: http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproductandproductID=1515 (дата обращения: 26.10.2018).
28. Szperka C.L., VanderPluym J., Orr S.L. et al. Recommendations on the Use of Anti-CGRP Monoclonal Antibodies in Children and Adolescents // Headache. 2018. Oct 15. [Epub ahead of print]. DOI: 10.1111/head.13414.
29. Orr S.L., Venkateswaran S. Nutraceuticals in the prophylaxis of pediatric migraine: Evidence-based review and recommendations // Cephalalgia. 2014. Vol. 34. P. 568–583.
30. Termine C., Ozge A., Antonaci F. et al. Overview of diagnosis and management of paediatric headache. Part II: therapeutic management // J Headache Pain. 2011. Vol. 12(1). P. 25–34.
31. Ludvigsson J. Propranolol used in prophylaxis of migraine in children // Acta Neurol. 1974. Vol. 50. P. 109–115.
32. Lewis D., Diamond S., Scott D. Prophylactic treatment of pediatric migraine // Headache. 2004. Vol. 44. P. 230–237.
33. Guidetti V., Moscato D., Ottaviano S. et al. Flunarizine and migraine in childhood an evaluation of endocrine function // Cephalalgia. 1987. Vol. 7. P. 263–266.
34. Hershey A.D., Powers S.W., Bentti A.L., deGrauw T.J. Effectiveness of amitriptyline in the prophylactic management of childhood headaches // Headache. 2000. Vol. 40. P. 539–549.
35. Winner P., Pearlman E., Linder S. et al. Topiramate for migraine prevention in children: a randomized, double-blind, placebo-controlled trial // Headache. 2005. Vol. 45. P. 1304–1312.
36. Serdaroglu G., Erhan E., Tekgul H. et al. Sodium valproate prophylaxis in childhood migraine // Headache. 2002. Vol. 42. P. 819–822.
37. Miller G.S. Efficacy and safety of levetiracetam in pediatric migraine // Headache. 2004. Vol. 44. P. 238–243.
38. Belman A.L., Milazo M., Savatic M. Gabapentin for migraine prophylaxis in children // Ann Neurol. 2001. Vol. 50(Suppl. 1). P. S109.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
