Headaches are one of the most common symptoms in daily medical practice. Migraine headache affects a substantial number of women in particular. The prevalence of migraine is estimated to be about 8% in men and 12–15% in women.1 Clinically, migraine is a throbbing or pulsating headache and is almost always associated with nausea, vomiting, sensitivity to light, sound and smell, sleep disruption and depression. A migraine headache typically begins on one side of the head and gradually increases in intensity over the next 1–2 h. Missed work and lost productivity from migraine create a significant public burden.
An episode of migraine may occur at any age. Attacks are often recurrent and tend to reduce in severity as the person ages. Migraine may result from a series of reactions in the brain provoked by changes in the body or in the environment such as change in the weather or time zone, lack of sleep, stress, hunger, certain medications and alcohol. It is a form of vascular headache caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels.
There is often a family history of the disorder, suggesting that there may be an inherited sensitivity to triggers that produce inflammation in the blood vessels and nerves around the brain, causing the pain. Some women experience migraine headaches just prior to or during menstruation. Known as menstrual migraines, these headaches may be related to hormonal changes and often not seen during pregnancy.
Mild-to-moderate migraine headache can be managed with the following approaches:
Headaches and migraine occur frequently in children and adolescents and may have a significant impact on the child’s and parents’ lives.3 According to the criteria of the International Headache Society, migraine occurs in about 5–10% of children.4 Early and effective treatment has long-term benefit and prevents disease progression.
Apart from management of acute headache, identification of migraine triggers, lifestyle adjustments and use of preventive therapy (when required) which include both nonpharmacologic or pharmacologic approach also forms part of the migraine treatment in children. In the acute migraine attack, a single dose of either ibuprofen 10 mg/kg or paracetamol 15 mg/kg has been shown to be effective, with only a few adverse effects.4
1.Diener HC, Katsarava Z, Limmroth V. Current diagnosis and treatment of migraine. Schmerz. 2008; 22(Suppl 1): 51–58 (Article in German).
2.Schürks M, Diener HC, Goadsby P. Update on the prophylaxis of migraine. Curr Treat Options Neurol. 2008; 10(1): 20–29.
3.Wojaczyńska-Stanek K, Koprowski R, Wróbel Z, Gola M. Headache in children's drawings. J Child Neurol. 2008; 23(2): 184–191.
4.Cuvellier JC, Joriot S, Auvin S, Vallée L. Pharmacologic treatment of acute migraine attack in children. Arch Pediatr. 2005; 12(3): 316–325 (Article in French).
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