Alison Marshall1, Rebecca Lindsay1, Michelle A Clementi2, Amy A Gelfand3, Serena L Orr4,5,6. 1. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 2. Departments of Psychiatry and Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 3. Child & Adolescent Headache Program, University of California San Francisco, San Francisco, CA, USA. 4. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. serena.orr@ucalgary.ca. 5. Departments of Community Health Sciences and Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. serena.orr@ucalgary.ca. 6. Alberta Children's Hospital, 28 Oki Drive NW, Calgary, AB, T3B 6A8, Canada. serena.orr@ucalgary.ca.
Abstract
PURPOSE OF REVIEW: Migraine is one of the top reasons for consulting a pediatric neurologist. Although the majority of children and adolescents who receive evidence-based first-line interventions for migraine will improve substantially, a subset of patients develop resistant or refractory migraine. RECENT FINDINGS: In this review, we summarize the level of evidence for a variety of acute and preventive treatment options to consider in children and adolescents with resistant or refractory migraine. We describe the level of evidence for interventional procedures (onabotulinumtoxinA injections, greater occipital and other nerve blocks), neuromodulation (single-pulse transcranial magnetic stimulation, external trigeminal nerve stimulation, remote electrical neuromodulation, and non-invasive vagal nerve stimulation), calcitonin gene-related peptide (CGRP) pathway antagonists (anti-CGRP monoclonal antibodies and gepants), psychological therapies, and manual therapies (acupuncture, craniosacral therapy, massage and physical therapy, and spinal manipulation).
PURPOSE OF REVIEW: Migraine is one of the top reasons for consulting a pediatric neurologist. Although the majority of children and adolescents who receive evidence-based first-line interventions for migraine will improve substantially, a subset of patients develop resistant or refractory migraine. RECENT FINDINGS: In this review, we summarize the level of evidence for a variety of acute and preventive treatment options to consider in children and adolescents with resistant or refractory migraine. We describe the level of evidence for interventional procedures (onabotulinumtoxinA injections, greater occipital and other nerve blocks), neuromodulation (single-pulse transcranial magnetic stimulation, external trigeminal nerve stimulation, remote electrical neuromodulation, and non-invasive vagal nerve stimulation), calcitonin gene-related peptide (CGRP) pathway antagonists (anti-CGRP monoclonal antibodies and gepants), psychological therapies, and manual therapies (acupuncture, craniosacral therapy, massage and physical therapy, and spinal manipulation).
Authors: Scott W Powers; Christopher S Coffey; Leigh A Chamberlin; Dixie J Ecklund; Elizabeth A Klingner; Jon W Yankey; Leslie L Korbee; Linda L Porter; Andrew D Hershey Journal: N Engl J Med Date: 2016-10-27 Impact factor: 91.245
Authors: Andrew Blumenfeld; Stephen D Silberstein; David W Dodick; Sheena K Aurora; Catherine C Turkel; William J Binder Journal: Headache Date: 2010-10 Impact factor: 5.887
Authors: Clare P Herd; Claire L Tomlinson; Caroline Rick; William J Scotton; Julie Edwards; Natalie J Ives; Carl E Clarke; A J Sinclair Journal: BMJ Open Date: 2019-07-16 Impact factor: 2.692