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    What is new in migraine management in children and young people?

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    URI
    https://rde.dspace-express.com/handle/11287/622463
    Author
    Loh, N. R.
    Whitehouse, W. P.
    Howells, R.
    Date
    2022-02-21
    Journal
    Archives of disease in childhood
    Type
    Journal Article
    Publisher
    BMJ
    DOI
    10.1136/archdischild-2021-322373
    Rights
    © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
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    Abstract
    For this narrative review, we found recent publications on the use and effectiveness of old therapies including nutraceuticals, such as riboflavin, vitamin D, magnesium, melatonin and talking therapies. Recent large trials of established conventional pharmaceuticals such as propranolol, pizotifen, topiramate and amitriptyline for childhood migraine have failed, but the use of a quasi-placebo in future trials could help. We reviewed the evidence for angiotensin antagonists including candesartan in adults, but found a lack of evidence for their use in children. There have been new developments in pharmaceuticals recently, including a more selective 5-HT1F agonist, lasmiditan, an effective acute treatment with no vasoconstrictor activity in adults, currently being tested in children. Also, a number of new calcitonin gene-related peptide (CGRP) antibodies and antagonists, with proven efficacy in acute treatment and/or prevention of migraine in adults, are undergoing trials in children. Peripheral nerve blocks and botulinum toxin are gaining popularity in adult practice, but we really need more good quality evidence for their effectiveness in children. Finally, electroceuticals, that is, therapeutic electric devices, are now marketed for acute and or preventative treatment, including an external trigeminal nerve stimulator (e-TNS), a non-invasive vagal nerve stimulator (nVNS), a single-pulse transcranial magnetic stimulator (sTMS) and a remote electrical neuromodulation device (REN). At the moment, evidence for their effectiveness in children is still lacking. So, there has been much progress, but mostly for adults. We are in urgent need of more migraine trials in children.
    Citation
    Arch Dis Child. 2022 Feb 21:archdischild-2021-322373. doi: 10.1136/archdischild-2021-322373.
    Publisher URL
    https://adc.bmj.com/lookup/pmidlookup?view=long&pmid=35190383
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    RD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.
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    • 2022 Eastern publications
    • Paediatrics (children and young people)

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