Migraine and Headache in Children and Adolescents

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (23 January 2022) | Viewed by 18408

Special Issue Editors


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Guest Editor
Pediatric Neurology Unit, Bnai Zion Medical Center, 31048 Haifa, Israel
Interests: classification, epidemiology and treatment of pediatric headaches; clinical neurology; neurological diseases; primary headache disorders

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Co-Guest Editor
Section of Child and Adolescent Neuropsychiatry, Department of Human Neuroscience, Sapienza—University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
Interests: headache; pain; psychopathology; comorbidity
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Special Issue Information

Dear Colleagues,

Headaches are common in children and adolescents. Indeed, they are the most common pain complaint among children and adolescents seeking medical advice, with their prevalence increasing with age. Migraine and tension-type headaches (TTHs) are by far the most frequently occurring types of headache in this age group. The prevalence of migraine increases with age up to 8–23% during the high school years. The mean age of onset for migraine is 7 years for boys and 11 years for girls.

Approximately 25% the children who have migraine report experiencing aura before onset of the headache. Visual aura is the most common type of aura, followed by sensory disturbances. Less frequent are speech disturbances. The duration for most aura symptoms is usually one hour, but motor symptoms may last for a longer time. Patients, especially young children, often find it hard to describe their symptoms.

Treatment strategies for migraine vary according to patient’s age, family structure, culture and beliefs and according to the disability the headache imposes on the patient’s daily living. A multidisciplinary treatment approach was found to be an effective strategy for children and adolescents. Drugs such as: Topiramate, Amitriptyline and Propranolol that were traditionally used for migraine prevention did not reach statistically significant improvement in RCT. New drugs, such as anti-GCRP, are still not registered for children.

This Special Issue will focus on the most updated pathophysiological, clinical, and therapeutic aspects of headache and migraine in children and adolescents.

Dr. Jacob Genizi
Prof. Dr. ‪Vincenzo Guidetti‬
Guest Editors

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Keywords

  • migraine
  • headache
  • children
  • adolescents
  • pathophysiology
  • treatment
  • medication

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Published Papers (5 papers)

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Editorial

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2 pages, 155 KiB  
Editorial
Special Issue “Migraine and Headache in Children and Adolescents”
by Jacob Genizi and Vincenzo Guidetti
Life 2022, 12(5), 704; https://doi.org/10.3390/life12050704 - 8 May 2022
Viewed by 1235
Abstract
Migraine in developmental age is a common pathology [...] Full article
(This article belongs to the Special Issue Migraine and Headache in Children and Adolescents)

Research

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11 pages, 242 KiB  
Article
Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
by Vincenzo Raieli, Mariarita Capizzi, Antonio Marino, Giovanni Di Nardo, Umberto Raucci and Pasquale Parisi
Life 2022, 12(3), 450; https://doi.org/10.3390/life12030450 - 18 Mar 2022
Cited by 7 | Viewed by 2113
Abstract
Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensory and motor system) may be affected on different levels. About a fourth of migraine patients have migraine auras. The most common aura is [...] Read more.
Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensory and motor system) may be affected on different levels. About a fourth of migraine patients have migraine auras. The most common aura is the visual aura followed by the sensorial aura but motor deficits, as well as deficits of higher cortical centers (disorders of thinking, orientation, coherence, or concentration), may occur as well. In analogy with a headache diary, an aura diary can deliver important help in the diagnostic process of rare migraine manifestations and prevent the under-diagnosis of unusual migraine manifestations. Complex migraine manifestations are a diagnosis of exclusion, and a broad diagnostic work-up is necessary in order to exclude dangerous neurologic pathologies. In addition, here, we discuss the atypical clinical presentation and possible physio-pathogenetic related aspects of these atypical migraine aura features in the developmental age. In addition, we wanted to stress and analyze the clinical aspects of our children/adolescents with atypical auras, which seem to be more difficult to frame with the mechanisms originally proposed to explain the physio-pathogenetic relationship between CSD and aura. Finally, we discuss in detail the complex aspects of this topic on the basis of available data and propose new terminology: “Multiple, Synchronous and Asynchronous, Cortical and Subcortical Spreading Depression”. Full article
(This article belongs to the Special Issue Migraine and Headache in Children and Adolescents)
51 pages, 1098 KiB  
Article
Pediatric Headache in Primary Care and Emergency Departments: Consensus with RAND/UCLA Method
by Giovanni Prezioso, Agnese Suppiej, Valentina Alberghini, Patrizia Bergonzini, Maria Elena Capra, Ilaria Corsini, Alessandro De Fanti, Elisa Fiumana, Martina Fornaro, Lucia Marangio, Paolo Ricciardelli, Laura Serra, Duccio Maria Cordelli, Susanna Esposito and the Emilia-Romagna Headache Study Group
Life 2022, 12(2), 142; https://doi.org/10.3390/life12020142 - 19 Jan 2022
Cited by 9 | Viewed by 6441
Abstract
Headache is the most frequent neurological symptom in childhood and the main reason for admission to pediatric emergency departments. The aim of this consensus document is to define a shared clinical pathway between primary care pediatricians (PCP) and hospitals for the management of [...] Read more.
Headache is the most frequent neurological symptom in childhood and the main reason for admission to pediatric emergency departments. The aim of this consensus document is to define a shared clinical pathway between primary care pediatricians (PCP) and hospitals for the management of children presenting with headache. For the purposes of the study, a group of hospital pediatricians and a group of PCP from the Emilia Romagna’s health districts were selected to achieve consensus using the RAND/UCLA appropriateness method. Thirty-nine clinical scenarios were developed: for each scenario, participants were asked to rank the appropriateness of each option from 1 to 9. Agreement was reached if ≥75% of participants ranked within the same range of appropriateness. The answers, results, and discussion helped to define the appropriateness of procedures with a low level of evidence regarding different steps of the diagnostic-therapeutic process: primary care evaluation, emergency department evaluation, hospital admission, acute therapy, prophylaxis, and follow-up. The RAND proved to be a valid method to value appropriateness of procedures and define a diagnostic-therapeutic pathway suitable to the local reality in the management of pediatric headache. From our results, some useful recommendations were developed for optimizing the healthcare professionals’ network among primary care services and hospitals. Full article
(This article belongs to the Special Issue Migraine and Headache in Children and Adolescents)
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Review

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15 pages, 269 KiB  
Review
Emerging Pharmacological Treatments for Migraine in the Pediatric Population
by Luigi Francesco Iannone, Francesco De Cesaris and Pierangelo Geppetti
Life 2022, 12(4), 536; https://doi.org/10.3390/life12040536 - 5 Apr 2022
Cited by 6 | Viewed by 3617
Abstract
Headaches in children and adolescents have high incidence and prevalence rates, with consequent elevated disability costs to individuals and the community. Pediatric migraine is a disorder with substantial clinical differences compared to the adult form. Few clinical trials have been performed specifically on [...] Read more.
Headaches in children and adolescents have high incidence and prevalence rates, with consequent elevated disability costs to individuals and the community. Pediatric migraine is a disorder with substantial clinical differences compared to the adult form. Few clinical trials have been performed specifically on primary headache in pediatric populations using acute and preventative treatments, often with conflicting findings. The limited high-quality data on the effectiveness of treatments are also due to the high placebo effect, in terms of reductions in both the frequency and intensity of migraine attacks in the pediatric population. The recent introduction of calcitonin gene-related peptide (CGRP) pathway inhibitors and ditans is changing the treatment of migraine, but the majority of the data are still limited to adulthood. Thus, few drugs have indications for migraine treatment in the pediatric age group, and limited evidence gives guidance as to the choice of pharmacotherapy. Herein, we review the current evidence of pharmacological treatments and ongoing clinical trials on acute and preventative treatments in the pediatric population with migraine. Full article
(This article belongs to the Special Issue Migraine and Headache in Children and Adolescents)
12 pages, 310 KiB  
Review
Migraine and Its Equivalents: What Do They Share? A Narrative Review on Common Pathophysiological Patterns
by Ilaria Frattale, Claudia Ruscitto, Laura Papetti, Fabiana Ursitti, Giorgia Sforza, Romina Moavero, Michela Ada Noris Ferilli, Samuela Tarantino, Martina Balestri, Federico Vigevano, Luigi Mazzone and Massimiliano Valeriani
Life 2021, 11(12), 1392; https://doi.org/10.3390/life11121392 - 12 Dec 2021
Cited by 5 | Viewed by 3794
Abstract
Migraine is the first in order of frequency of the neurological disorders, affecting both adult and paediatric populations. It is also the first cause of primary headaches in children. Migraine equivalents are periodic disorders that can be associated with migraine or considered as [...] Read more.
Migraine is the first in order of frequency of the neurological disorders, affecting both adult and paediatric populations. It is also the first cause of primary headaches in children. Migraine equivalents are periodic disorders that can be associated with migraine or considered as prognostic features of a future migraine manifestation. Despite the mechanisms underlying migraine and its equivalents are not entirely clear, several elements support the hypothesis of common pathophysiological patterns shared by these conditions. The aim of this review is thus to analyze the literature in order to highlight which currently known mechanisms may be common between migraine and its equivalents. Full article
(This article belongs to the Special Issue Migraine and Headache in Children and Adolescents)
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