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Guideline review
Acute treatment of migraine in children and adolescents: review of the American Academy of Neurology Practice guideline update
  1. Daniel Cromb,
  2. Dionysios Grigoratos
  1. General Paediatrics, King's College Hospital NHS Trust, London, UK
  1. Correspondence to Dr Daniel Cromb, General Paediatrics, King's College Hospital NHS Trust, London, UK; daniel.cromb{at}nhs.net

https://doi.org/10.1136/archdischild-2019-318580

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    Background

    Migraine is a brain disease that involves episodes of medium to severe headaches along with specific associated symptoms, including nausea, vomiting, photophobia and phonophobia, as defined by criteria developed by the International Headache Society. It is a common and disabling condition in children, estimated to affect ~10% of girls and ~6% of boys1 and it accounts for ~2% of visits to the emergency department in the USA.2 Migraines can disrupt life activities, such as participation in home, school and social functions, and can have a negative effect on quality of life. They can also be challenging to manage. This review aims to summarise the latest evidence-based information for the acute treatment of migraines. Prophylactic treatment options for migraine are outside the scope of this article and will not be addressed here.

    Information about the current guideline

    The aim of the American Academy of Neurology (AAN) guideline is to provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine, for use by healthcare practitioners, patients and their families (see box 1).

    Box 1

    Resources

    American Academy of Neurology (AAN) practice guideline update summary: acute treatment of migraine in children and adolescents

    • Full guideline: https://n.neurology.org/content/93/11/487.long 5

    • Clinician summary: https://www.aan.com/Guidelines/home/GetGuidelineContent/970

    • Patient summary: https://www.aan.com/Guidelines/home/GetGuidelineContent/972

    Other useful resources for the investigation and management of migraine in children and adolescents:

    • National Institute forHealth and Care Excellence guideline: headaches in over 12-year-olds: diagnosis and management

      clinical guideline (CG150). Published date: September 2012. Last updated: November 2015

      https://www.nice.org.uk/guidance/CG150

    • British Association for the Study of Headache (BASH) guideline: guidelines for all healthcare professionals in the diagnosis and management of migraine, tension type, cluster and medication-overuse headache

      Published by: BASH. Last published: 2010

      https://www.bash.org.uk/wp-content/uploads/2012/07/10102-BASH-Guidelines-update-2_v5-1-indd.pdf 6

    • AAN practice guideline update summary: pharmacological treatment for paediatric migraine prevention. Published September 20193 https://www.aan.com/Guidelines/home/GetGuidelineContent/978

    The guideline was approved by the AAN Guideline Development Dissemination …

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    Footnotes

    • Twitter @dancromb, @DNGrigoratos

    • Contributors DC wrote and edited the manuscript. DG edited the manuscript. Both authors approved the final draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.