Region-specific changes in brain glutamate and gamma-aminobutyric acid across the migraine attack in children and adolescents.

In patients with migraine, an excitation-inhibition imbalance that fluctuates relative to attack onset has been proposed to contribute to the underlying pathophysiology of migraine, but this has yet to be explored in children and adolescents. This prospective, observational, cohort study examined glutamate and gamma-aminobutyric acid (GABA) levels across the phases of a migraine attack and interictally in children and adolescents using magnetic resonance spectroscopy. Macromolecule-suppressed GABA (sensorimotor cortex and thalamus) and glutamate (occipital cortex, sensorimotor cortex, and thalamus) were measured in children and adolescents (10-17 years) with a migraine diagnosis with or without aura 4 times over 2 weeks.

Pediatric migraine teaching for families.

Purpose: Child and family education regarding management of pediatric migraine is essential to reduce acute pain, prevent chronic daily migraine, and minimize the total number of headache attacks. This paper summarizes current evidence and provides a foundation for family teaching.

Conclusions: Effective management of pediatric migraine can be achieved with a combination of individually tailored biobehavioral strategies, lifestyle modifications, and optimal scheduling of rescue and preventative pharmacologic treatment.