title: Treating pediatric migraine: an expert opinion.
abstract: BACKGROUND
  Headaches are common in children and adolescents and migraine affects almost 8% of this population. As revisions are made to the ICHD-II criteria to include additional characteristics of pediatric migraine, the diagnosis of migraine is expected to increase. Therefore, it is important to understand and apply successful treatment in acute migraine. Patients and families should be educated about the options for migraine treatment that includes both pharmacologic and conservative behavioral techniques in managing headaches.
  
  
  METHODS
  This review examines the studies that have been performed in pediatric patients, in addition to exploring the treatment options commonly used in pediatrics and adolescents for migraine and their rationale for use.
  
  
  CONCLUSIONS
  For the acute treatment of migraine, we recommend the use of ibuprofen or acetaminophen for mild, moderate or severe headache. For moderate to severe headache, or for headaches that fail to respond to over-the-counter medications, we recommend the use of a triptan or combination NSAID/triptan therapy. For preventative treament of migraine, cyproheptadine should be reserved for younger children unable to swallow tablets while amitriptyline is preferred due to its once daily dosing and minimal side effects. Topiramate and divalproate are considerable options depending on patient co-morbid profile and preference.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Hope L
authors.initials: HL
authors.lastname: O'Brien
authors.forename: Marielle A
authors.initials: MA
authors.lastname: Kabbouche
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hershey
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D001521:Behavior Therapy; D002648:Child; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000700:Analgesics; D000082:Acetaminophen; D007052:Ibuprofen