Management of migraine in children and adolescents.

Successful management of migraine in childhood and adolescence starts with making the correct diagnosis, assessing the impact of migraine on the child/adolescent's quality of life including impact on education, family life, and social activities. Understanding the child's and family's concerns and reasons for seeking medical advice is an important starting point in the management plan. Pharmacological treatment should go hand-in-hand with appropriate advice on maintaining a healthy life style, avoidance of triggers and aggravating factors, and exploring comorbid disorders that may influence response to treatment.

Migraine in children and adolescents: Assessment and diagnosis.

Migraine is a complex, multifactorial brain disorder, and its presentation, complications, and response to treatment often follow the biopsychosocial model. Therefore, assessment and management include the wider aspects of the child's life within the family, at school, with peers, and in relation to his/her neurologic and emotional development. The diagnosis of headache disorders in children relies heavily on taking a careful clinical history, carrying out an appropriate physical and neurologic examination and a skilled interpretation of the findings.

Guidelines Update: Guidelines of the International Headache Society for controlled trials of preventive treatment of migraine in children and adolescents, 1st edition - An experience-based update.

Background: Recent experience in designing and running clinical trials on new medications for the prevention of migraine in children and adolescents highlighted the need for revision of the 1st edition of the International Headache Society Guidelines for clinical trials of preventive treatment of migraine in children and adolescents which were published in 2019.

Methods: The authors of the 1st edition of the guidelines formed an informal focus group with aims of appraising the performance of the guidelines, clarifying any ambiguity and providing improvements, where needed, based on personal experience and expert analysis.

Results: This review and the following update were able to address issues related to the classification of migraine, the duration of migraine attacks, the age groups of children and adolescents, the use of electronic diaries, the assessment of outcome measures, the need for an interim analysis and the issues related to placebo response.

Headache and Psychological Comorbidities: An Appraisal of the Evidence.

Background: It has been observed that there is a higher-than-expected risk of anxiety and depression in children with chronic headache and also an increased risk for the persistence of headache in patients with anxiety and depression.

Objectives: This review aims to identify and assess the relationships between primary headache disorders and comorbid emotional and psychological disorders.

Methods: A targeted review of the literature was carried out.