AAN-AHA updated pediatric migraine guidelines: Treat as soon as the child becomes aware of an impending migraine attack

Dr KK Aggarwal

The American Academy of Neurology (AAN) and the American Headache Society (AHS) have published updated recommendations for preventing and treating migraine in children and adolescents

The guidelines focused on two areas: one, acute treatments to reduce pain and other symptoms that accompany the headache and secondly, treatments to prevent migraine attacks and reduce the associated morbidity. Some key recommendations are:

·         Migraine should be treated as soon as the child or the adolescent becomes aware of an attack starting. Treatment is most effective when given early in the attack.

·         A detailed history and physical examination, including a neurological examination that may need to be conducted by a neurologist or headache medicine specialist is recommended.

·         Educate the patients and their parents about migraine and factors that trigger the episode such as lack of physical activity, being overweight, excessive caffeine intake, poor sleep habits and dehydration

·         Mood disorders (depression and anxiety) often co-occur with migraine. Adopting a healthy lifestyle – healthy eating, physical activity, adequate hydration and adequate sleep will help in managing them.

·         The risks and benefits of preventive medication and appropriate acute treatment should be discussed with the patients.

·         Ibuprofen, triptans and combination sumatriptan/naproxen may be used to relieve pain.

The guidelines are published in the August 14, 2019, online issue of the journal Neurology.

(Source: American Academy of Neurology)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA