sought. Several triptans are currently under investiga-
Current approaches to the diagnosis and
tion for their effectiveness in children (Reference 29).
A few trials are also investigating topiramate for use in
preventing migraines in children 12 years and older.
CONCLUSIONS
Migraines occur commonly in the pediatric population.
They can be debilitating and affect the school, social,
and home life of a child. Appropriate diagnosis and
close follow-up with monitoring are recommended
for all patients. Nonpharmacologic and pharmacologic
therapies should be used in children with a diagnosis of
migraines to improve symptoms and increase quality of
life. Biofeedback, relaxation techniques, and stress man-
agement are nonpharmacologic therapies to consider in
children with migraines. Ibuprofen or acetaminophen
is an appropriate first-line short-term nonprescription
treatment option, with the triptan class considered a
first-line prescription treatment option for children
and adolescents. Several medications (e.g., propranolol,
amitriptyline, valproic acid, topiramate) have been used
for prophylaxis therapy in children. The understanding
of this disease state, assessment, and treatment will con-
tinue to change as they are further studied. Migraine
management will continue to expand as evidence is dis-
covered regarding new short-term and preventive drugs
as well as nonpharmacologic strategies.
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