Approach to Pediatric Intractable Migraine.
Mohammed AlqahtaniRebecca BarmherzigAnna Marissa Lagman-BartolomePublished in: Current neurology and neuroscience reports (2021)
A comprehensive approach in the evaluation and management of intractable migraine in this age group encompasses excluding secondary causes of headache; making an accurate diagnosis; identifying and appropriately managing modifiable risk factors; and initiating appropriate pharmacologic therapy to reduce disability, improve health-related quality of life, reduce risk of progression, and develop adaptive pain coping strategies. Several strategies for management of pediatric intractable migraine including use of acute medications, bridge therapy in outpatient setting, emerging therapies for preventive therapy, and a stepwise combination therapy for management of pediatric intractable migraine in emergency and inpatient setting are presented based on available clinical data, safety/tolerability, availability, cost-effectiveness, and expert consensus. This descriptive review of the available literature focuses on approach to therapy for acute intractable migraine in a pediatric population including outpatient, emergency department (ED), and inpatient management.
Keyphrases
- emergency department
- risk factors
- liver failure
- palliative care
- mental health
- multiple sclerosis
- stem cells
- respiratory failure
- depressive symptoms
- chronic pain
- machine learning
- high resolution
- spinal cord injury
- electronic health record
- young adults
- open label
- cross sectional
- cell therapy
- extracorporeal membrane oxygenation
- study protocol
- replacement therapy