Migraine in children and adolescents

Migraine is the most common and most disabling neurological disorder in children and adolescents. It affects 1 in 10 children between 5 and 16 years of age. Although headache is the most prominent symptom, nausea, vomiting, intolerance to light and noise and dizziness can be as bothersome to patients. The migraine episode can go through several phases and may last for 3 days. Migraine has a significant impact on children's quality of life, school attendance, and educational achievement and the more frequent the episodes the greater the impact. The management of migraine follows the biopsychosocial model. For successful treatment of the migraine episode, patients should avoid aggravating factors, take medications as early as possible after onset of headache in the recommended dose and formulation. For preventive treatment, patients can help reduce the frequency and severity of migraine by adopting a healthy lifestyle with regular meals, sleep and exercise, and avoiding excessive screen time. Preventive treatment is recommended for patients with frequent and prolonged episodes with impact on child's normal activities. However, the current available medications are non-specific, have inadequate efficacy, and have issues with tolerability and adverse effects. Therefore, patients and their families should take part in making the decision to start preventive medication.