Serum Prolactin in Diagnosis of Epileptic Seizures
Pediatric Neurology Briefs
probably effective for acute treatment of migraine in children. Sumatriptan nasal spray was effective and was recommended for use in adolescents. Except for the calcium channel blocker, flunarizine, which is unavailable in the United States, trials of medications in the prophylactic management of migraine in children are inconclusive. These include anticonvulsants, antidepressants, antihistamines, and antihypertensive agents. Medication-overuse headache. The overuse of analgesic medications is
... sic medications is stressed as a factor in the development of rebound and chronic daily headaches (CDH), and the withdrawal of all headache medications is recommended in their management (Wiendels NJ et al. Headache 2005;45:678-683; Ped Neur Briefs July 2005; 19:56). Used in moderation, non-steroidal anti-inflammatory analgesics are relatively safe and effective; when taken 15 days or more per month for 3 months or longer, they are likely to induce "medication overuse headache (MOH)" (Limmroth V, Katsarava Z. Curr Opin Neurol 2004;17:301-306). In Norway, the prevalence of CDH in the general population is 2 -4%, and MOH accounts for one third of these cases; and 10% of the population is reported to take analgesics on a daily basis (Zwart JA et al. Neurology 2003;61:160-164). MOH is not only a problem of adults; it also occurs in children, even as young as 6 years (Hering-Hanit R et al. J Child Neurol 2001;16:448-449). MOH can result from overuse of any of the anti-migraine medications, including analgesics, triptans, ergots and medications containing barbiturates, tranquilizers, codeine and caffeine. A more general understanding of the risks of analgesic overuse should lead to a greater reliance on the recognition and avoidance of migraine triggers (Millichap JG, Yee MM. Pediatr Neurol 2003;28:9-15), and the support of controlled studies of prophylactic medications in childhood migraineurs.