Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society

Maryam Oskoui, Tamara Pringsheim, Yolanda Faye Holler-Managan, Sonja Potrebic, Lori Billinghurst, David Gloss, Andrew D. Hershey, Nicole Licking, Michael Sowell, M. Cristina Victorio, Elaine M. Gersz, Emily Leininger, Heather Zanitsch, Marcy Yonker, Kenneth Mack

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

ObjectiveTo provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine.MethodsWe performed a systematic review of the literature and rated risk of bias of included studies according to the American Academy of Neurology classification of evidence criteria. A multidisciplinary panel developed practice recommendations, integrating findings from the systematic review and following an Institute of Medicine-compliant process to ensure transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence.ResultsThere is evidence to support the efficacy of the use of ibuprofen, acetaminophen (in children and adolescents), and triptans (mainly in adolescents) for the relief of migraine pain, although confidence in the evidence varies between agents. There is high confidence that adolescents receiving oral sumatriptan/naproxen and zolmitriptan nasal spray are more likely to be headache-free at 2 hours than those receiving placebo. No acute treatments were effective for migraine-related nausea or vomiting; some triptans were effective for migraine-related phonophobia and photophobia.RecommendationsRecommendations for the treatment of acute migraine in children and adolescents focus on the importance of early treatment, choosing the route of administration best suited to the characteristics of the individual migraine attack, and providing counseling on lifestyle factors that can exacerbate migraine, including trigger avoidance and medication overuse.

Original languageEnglish (US)
Pages (from-to)487-499
Number of pages13
JournalNeurology
Volume93
Issue number11
DOIs
StatePublished - Sep 10 2019

ASJC Scopus subject areas

  • Clinical Neurology

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