title: The optimal management of headaches in children and adolescents.
abstract: The recognition of the diagnosis of migraine in children is increasing. Early and aggressive treatment of migraine in this population with the use of over-the-counter medications has proven effective. The off-label use of many migraine-specific medications is often accepted in the absence of sufficient evidenced-based trials. Mild to severe cases of migraine should be treated with nonsteroidal anti-inflammatory drugs, with triptans used in moderate to severe headaches unresponsive to over-the-counter therapy. Rescue medication including dihydroergotamine [DHE] should be used for status migrainosus, preferably in the hospital setting. Antiemetics that have antidopaminergic properties can be helpful in patients with associated symptoms of nausea and vomiting through their action on central migraine generation. Furthermore, patients and families should be educated on nonpharmacologic management such as lifestyle modification and avoidance of triggers that can prevent episodic migraine.
authors.affiliation: Division of Neurology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnett Avenue, Cincinnati, OH 45229, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kacperski
authors.affiliation: Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Marielle A
authors.initials: MA
authors.lastname: Kabbouche
authors.affiliation: Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Hope L
authors.initials: HL
authors.lastname: O'Brien
authors.affiliation: Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Weberding
keywords: headache; migraine; pediatric headache