Acute Treatment of Migraine in Children and Adolescents: AAN guidelines
The Academy of Neurology (AAN) supported by the American Headache Society, have recently laid down a revised set of guidelines on the Acute management of Migraine in Children and Adolescents which have been published in the prestigious JAMA Pediatrics.
It serves as an update to the AAN's 2004 guidelines on short-term treatment in new and established patients with migraine.
In the updated guidelines, Dr. Irene Patniyot and Dr.William Qubty have elaborated that Migraine is a primary headache disorder with recurrent attacks of headache of moderate to severe intensity.Pediatric migraine is a common and potentially disabling disorder with an 8% to 24% prevalence in school-aged children. Reports have shown more than one quarter of children with migraine are associated with moderate or severe disability.
The revised guidelines, which conforms to Institute of Medicine standards in its development and evidence base, was initiated and funded by the American Academy of Neurology (AAN)with support from the American Headache Society.
Key recommendations of the guidelines are-
- 1) To establish a specific headache type as primary, secondary, or other (level B).the rationale is to access the type of management needed as short-term migraine treatments are more effective when the pain is still mild (level B).
- 2) To determine about premonitory and aura symptoms, headache description, associated symptoms, and pain-associated disability (level B)
- 3) Ibuprofen (10 mg/kg) is an initial pain treatment option (level B).
- 4) For adolescents with migraine, clinicians should prescribe sumatriptan/naproxen oral tablets, zolmitriptan nasal spray, sumatriptan nasal spray, rizatriptan oral dissolving tablets, or almotriptan tablets (level B) with a second dose administered within 24 hours if needed.
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