Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification

James A. Charles, B. L. Peterlin, Alan M. Rapoport, Steven L. Linder, Marielle A. Kabbouche, Fred D. Sheftell

Research output: Contribution to journalReview articlepeer-review

Abstract

There is evidence that the prevalence of migraine in children and adolescents may be increasing. Current theories of migraine pathophysiology in adults suggest activation of central cortical and brainstem pathways in conjunction with the peripheral trigeminovascular system, which ultimately results in release of neuropeptides, facilitation of central pain pathways, neurogenic inflammation surrounding peripheral vessels, and vasodilatation. Although several risk factors for frequent episodic, chronic, and refractory migraine have been identified, the causes of migraine progression are not known. Migraine pathophysiology has not been fully evaluated in children. In this review, we will first discuss the evidence that early therapeutic interventions in the child or adolescent new onset migraineur, may halt or limit progression and disability. We will then review the evidence suggesting that many adults with chronic or refractory migraine developed their migraine as children or adolescents and may not have been treated adequately with migraine-specific therapy. Finally, we will show that early, appropriate and optimal treatment of migraine during childhood and adolescence may result in disease modification and prevent progression of this disease.

Original languageEnglish (US)
Pages (from-to)227-233
Number of pages7
JournalJournal of Headache and Pain
Volume10
Issue number4
DOIs
StatePublished - Aug 2009

Keywords

  • Adolescent
  • Child
  • Disease modification
  • Migraine

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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