Review of pediatric migraine headaches refractory to medical management

Theodore A. Kung, Ali Totonchi, Yashar Eshraghi, Mark S. Scher, Arun K. Gosain

Research output: Contribution to journalArticle

3 Scopus citations


Objective: The surgical treatment of migraine headache is a recent innovation that has broadened the potential patient population who may benefit from craniofacial surgical techniques to millions of affected adults. However, the population at risk in the pediatric age group has not been clearly established. The present retrospective review was performed to provide demographic information of the adolescent migraine in a major children's hospital. This information is essential before considering surgical treatment of migraine in this age group. Methods: Five hundred eighty-eight charts of patients aged 12 to 18 years who presented to the pediatric neurology clinic with headache in 2006 were retrospectively reviewed to evaluate for the diagnosis of migraine. Data collected included headache location, frequency, duration, intensity, associated migraine symptoms, and headache precipitants, as well as the response to medical treatment. Results: Two hundred ten (36%) of 588 patients had the diagnosis of migraine headache, and 51 patients (24%) were considered refractory to the medical treatment offered. In 101 of the 210 migraine patients, anatomic location of the headaches could be identified. Thirty-nine children (19%) with refractory migraines (mean age, 14.7 years [SD, 0.3 years]) reported definitive migraine triggers. Conclusions: A significant percentage of pediatric patients with migraine headache remain refractory to medical treatment. At present, there is no good treatment regimen for migraine headaches in the pediatric population. We believe that surgical treatment of migraine headaches may be a realistic option for these patients.

Original languageEnglish (US)
Pages (from-to)125-128
Number of pages4
JournalJournal of Craniofacial Surgery
Issue number1
StatePublished - Jul 16 2009


  • Anatomic trigger points
  • Headache treatment
  • Headaches
  • Migraine headaches
  • Pediatrics

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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