Prophylactic treatment of migraine in children. Part 1. A systematic review of non-pharmacological trials.
The aim of this study was to assess the efficacy of non-pharmacological prophylactic treatments of migraine in children. Databases were searched from inception to June 2004 and references were checked. We selected controlled trials reporting the effects of non-pharmacological prophylactic treatments in children with migraine. We assessed trial quality using the Delphi list and extracted data. Analyses were carried out according to type of intervention. A total of 19 trials were included. Relaxation, relaxation + biofeedback, relaxation + biofeedback + cognitive behavioural treatment were more effective compared with waiting list controls. Relaxation + behavioural therapy was more effective than placebo. There is conflicting evidence for the use of oligoantigenic diets. A few non-pharmacological treatments such as relaxation may be effective as prophylactic treatment for migraine in children. Because of the small number of studies and the methodological shortcomings, conclusions on effectiveness have to be drawn with caution.
Department of General Practice, Erasmus Medical Centre, Rotterdam, the Netherlands.
L
L
Damen
J
J
Bruijn
B W
BW
Koes
M Y
MY
Berger
J
J
Passchier
A P
AP
Verhagen
D000700:Analgesics / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy / Q000379:methods / Q000706:statistics & numerical data; D004035:Diet Therapy / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D011315:Preventive Medicine / Q000379:methods / Q000706:statistics & numerical data; D012064:Relaxation Therapy / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D000700:Analgesics