Intravenous Migraine Treatment in Children and Adolescents
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CHILDHOOD AND ADOLESCENT HEADACHE (S EVERS, SECTION EDITOR)
Intravenous Migraine Treatment in Children and Adolescents Klaus G. Werner 1 & Sharoon Qaiser 2 & Marielle A. Kabbouche 3 & Beverly Murphy 4 & Ian Maconochie 5 & Andrew D. Hershey 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Pediatric migraine is a common, chronic, and disabling neurological disorder in children and adolescents. Outpatient management is not always effective, and intravenous migraine management may be necessary for headache treatment in the pediatric emergency department. Most current treatment is based on retrospective evidence and there is a lack of welldesigned randomized double-blinded controlled pediatric studies. Intravenous drug treatment agents including intravenous fluids, prochlorperazine, diphenhydramine, metoclopramide, dexamethasone, magnesium, valproate and propofol, and dihydroergotamine are reviewed in this paper. Recent Findings Nineteen studies were reviewed including one prospective randomized double-blind; one single-blinded randomized; one prospective; and one open-label, randomized clinical trial. Most studies were retrospective and the quality of the studies was limited. Summary No definite conclusions can be drawn from the studies, but appropriate prospective trials between major pediatric headache institutions will move pediatric intravenous migraine management forward. Keywords Pediatric migraine . Intravenous treatment . Acute treatment . Status migrainosus
Introduction Migraine is a severe complex inherited sensory processing disorder, ranked among the top six disabling neurological disorders by the World Health Organization [1•]. It is a common chronic disabling neurological disorder in children and adolescents with an estimated world prevalence of 7.7% [2]. Pediatric migraine has a higher prevalence in children from a lower socioeconomic background [3], and school children and adolescents with migraine have a lower quality of life
measures and poorer academic performance [4]. Pediatric migraine remains a clinical diagnosis and is defined by the International Classification of Headache Disorders [5]. Pediatric headaches can be of shorter duration, with a lower limit of 1 h and are more likely to be bilateral. Physicians or pediatric neurologists need to ask about the child’s behavior as young children may not be able to describe or articulate common features such as photophobia and phonophobia [6]. Headache type, their frequency and severity, as well as the number of school days missed were significantly improved
Sharoon Qaiser contributed equally to this work. This article is part of the Topical Collection on Childhood and Adolescent Headache * Klaus G. Werner [email protected]
3
Division of Neurology, Cincinnati Children’s Hospital Medical Center/University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
Sharoon Qaiser [email protected]
4
Medical Center Library & Archives, Duke University Medical Center, Durham, NC 27710, U
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