Modern approaches to diagnostics and treatment of migraine in children

  • P V Kovalchuk Vinnytsia regional pediatric clinical hospital
  • O V Katilov Vinnytsia National Pirogov Memorial Medical University
  • S O Panenko Vinnytsia regional pediatric clinical hospital


This article reviews modern approaches to diagnostics and treatment of a very common and simultaneously underestimated and often maltreated disorder in children. It is fallacious management of migraine masked behind the diagnoses such as autonomic vessel dysfunction and vascular headache here in Ukraine. This is a tremendous problem and it should be solved with appropriate information spread across the medical community.

Up-to-date classification according to the International Headache Society, diagnostic criteria, differential diagnosis, investigation and treatment strategies are presented in the article. All supported data are com-pliant with guidelines of developed countries with evidence-based medicine (US, Canada, Great Britain, Japan, Australia, New Zealand) enhanced with new trials and approved methods. Migraine management is a rapidly evolving concept, where major changes were done during recent years (transcranial Deep Brain Stimulation, vagus stimulation, CGRP-receptor mono-clonal antibodies).

Considering disorder incidence and its impact on life quality and the existence of options for alleviating symptoms, this information is important for physicians who work with children, especially for general practitioners, pediatrics, pediatric and adult neurologists.


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Атлас головного болю (випущено ВООЗ, сумісно з Lifting the Burden (глобальна компанія проти головного болю) в2011 році)

The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018, Vol. 38(1) 1–211 ! International Headache Society 2018

GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990– 2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1545–1602–6736(16)31678–6/abstract

Clinical Practice Guideline for Chronic Headache 2013, Japanese Society of Neurology, Japanese Headache Society, Guideline Executive Committee

Freitag FG, Schloemer F, Shumate D. Recent Developments in the Treatment of Migraine in Children and Adolescents. Headache Pain Manag. Case Rep. 2016, 1:1. Офіційний сайт міжнародної класифікації головного болю ІІІ

Management of chronic headache, Roy G Beran, Australian Fami-ly Physician, Volume 43, No.3, March 2014, The Royal Australian College of General Practitioners 2016

Headache, Clinical Practice Guidelines, The Royal Children’s Hospital Melbourne

Forthys PA, Posner JB, Headache in patients with brain tumors; A STUDY OF 111 PATIENTS. Neurology. 1993 Sep. 43 (9): 1678–83.

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis– endorsed by the Eu-ropean Academy of Neurology, 20 August 2017.

Cerebral Sinovenous Thrombosis, Department of Neurology and Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, United States, Front. Pediatr., 27 July 2017

Craniocervical Arterial Dissection in Children: Diagnosis and Treatment, Curr Treat Options Neurol. 2011 Dec; 13(6): 636–648.,

Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine, January 12, 2017, N Engl J Med 2017; 376:115–124, DOI: 10.1056/NEJMoa1610384

Headaches in over 12s: diagnosis and management, Clinical guideline [CG150] Published date: September 2012 Last updat-ed: November 2015, NICE

Cervical non-invasive vagus nerve stimulation (nVNS) for preventive and acute treatment of episodic and chronic migraine and migraine-associated sleep disturbance: a prospective observational cohort study, J Headache Pain. 2015;16:101. doi: 10.1186/s10194–015–0582–9. Epub 2015 Dec 3

FDA Clears Vagus Nerve Stimulator for Migraine Pain, Deborah Brauser, January 29, 2018

Current management of amaurosis fugax. The Amaurosis Fugax Study Group. Stroke. 1990;21:201–208

Fremanezumab for the Preventive Treatment of Chronic Migraine, November 30, 2017, N Engl J Med 2017; 377:2113–2122, DOI: 10.1056/NEJMoa1709038

Treatment of Pediatric Migraine: a Review, Maedica (Buchar). 2016 Jun; 11(2): 136–143.

Spontaneous Subarachnoid Hemorrhage in Children, Mark Getzoff, MS4, Brahm Goldstein, MD,PEDIATRICS IN REVIEW Vol. 20 No. 12 December 01, 1999, pp. 422

Vascular anomalies of the head and neck in children, Kate Mahady, Stefanie Thust, Rupert Berkeley, Sam Stuart, Alex Barna-cle, Fergus Robertson, and Kshitij Mankad, Quant Imaging Med Surg. 2015 Dec; 5(6): 886–897.

Vertigo and Dizziness in Childhood – Update on Diagnosis and Treatment, K. Jahn, T. Langhagen, A.S. Schroeder, F. Heinen, July 15, 2011, Neuropediatrics, 42:129–134. DOI–1283158

Pathophysiology, clinical features, and diagnosis of migraine in children, Dec 29, 2017, Amy Gelfand, MD,

Brain stem activation in spontaneous human migraine attacks, AU, Weiller C, May A, Limmroth V, Jüptner M, Kaube H, Schayck RV, Coenen HH, Diener HC, SO Nat Med. 1995;1(7):658.

Rowe E, Cooper TE, McNicol ED. Ketorolac for postoperative pain in children (Protocol). Cochrane Database of Sys-tematic Reviews 2016, Issue 7. Art. No.: CD012294. DOI: 10.1002/14651858.CD012294

Amaal J Starling et al. A multicenter, prospective, single arm, open label, observational study of sTMS for migraine prevention (ESPOUSE Study), Cephalalgia 2018, Vol. 38(6) 1038–1048 ! In-ternational Headache Society 2018

Migraine Art: The Migraine Experience from Within, Klaus Podoll, Derek Robinson, North Atlantic Books, 2008

Preventive treatment of migraine in children, Kenneth J Mack, MD, PhD, Nov 14, 2016,

Lewis D, Ashwal S, Hershey A, et al. Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology 2004; 63:2215.

El-Chammas K, Keyes J, Thompson N, et al. Pharmacologic treatment of pediatric headaches: a meta-analysis. JAMA Pediatr 2013; 167:250.

МІНІСТЕРСТВО ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ, Департамент фармацевтичної діяльності, Державний експертний центр Міністерства охорони здоров’я України, “Державний реєстр лікарських засобів”

New Treatment Options: Anti-CGRP Monoclonal Antibodies for Migraine Prevention, Deborah Friedman, MD, MPH, FAHS, De-cember06,2018, American Headache Society and Medscape,

How to Cite
Kovalchuk PV, Katilov OV, Panenko SO. Modern approaches to diagnostics and treatment of migraine in children. PMJUA [Internet]. 2019Feb.21 [cited 2019Jun.25];3(4):41-3. Available from: