TY - JOUR
T1 - Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification
AU - Charles, James A.
AU - Peterlin, B. L.
AU - Rapoport, Alan M.
AU - Linder, Steven L.
AU - Kabbouche, Marielle A.
AU - Sheftell, Fred D.
PY - 2009/8
Y1 - 2009/8
N2 - 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.
AB - 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.
KW - Adolescent
KW - Child
KW - Disease modification
KW - Migraine
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UR - http://www.scopus.com/inward/citedby.url?scp=67650535667&partnerID=8YFLogxK
U2 - 10.1007/s10194-009-0133-3
DO - 10.1007/s10194-009-0133-3
M3 - Review article
C2 - 19506799
AN - SCOPUS:67650535667
SN - 1129-2369
VL - 10
SP - 227
EP - 233
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
IS - 4
ER -