nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2021-6-111-116nnp-1715Research ArticleREVIEWSОБЗОРЫMigraine in children and adolescents: modern principles of diagnostics and treatmentМигрень у детей и подростков: современные принципы диагностики и леченияhttps://orcid.org/0000-0002-2752-4109ГоловачеваВ. А.GolovachevaV. A.

Кафедра нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Россия, 119021, Москва, ул. Россолимо, д. 11, стр. 1 

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Build. 1, Moscow 119021, Russia 

xoxo.veronicka@gmail.comhttps://orcid.org/0000-0002-2845-7323ГоловачеваА. А.GolovachevaA. A.

Кафедра нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Россия, 119021, Москва, ул. Россолимо, д. 11, стр. 1 

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Build. 1, Moscow 119021, Russia 

https://orcid.org/0000-0002-4400-8632АнтоненкоЛ. М.AntonenkoL. M.

Кафедра нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского

Россия, 119021, Москва, ул. Россолимо, д. 11, стр. 1 

 Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Build. 1, Moscow 119021, Russia 

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияN.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation202116122021136111116Copyright © Golovacheva V.A., Golovacheva A.A., Antonenko L.M., 20212021Головачева В.А., Головачева А.А., Антоненко Л.М.Golovacheva V.A., Golovacheva A.A., Antonenko L.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1715

Migraine is a nervous system disorder that affects 7.7% of children and can debut before the age of 3 years. As they get older, the incidence of migraine increases, and among adolescents, its prevalence reaches 15%. The disease can significantly reduce the child's daily activity, school performance. Migraine is the most common cause of headache in children and adolescents, but it is not always diagnosed; it is not uncommon for patients with migraine to be misdiagnosed and given ineffective treatment. An effective approach to the diagnosis of migraine in children is presented, diagnostic criteria for migraine according to the 3rd edition of International Classification of Headache Disorders are described. Special disorders in childhood are described – episodic syndromes in children associated with migraine. Migraine treatment in children includes four main approaches: 1) lifestyle recommendations; 2) migraine attack treatment; 3) nonpharmacological treatment; 4) migraine preventive pharmacotherapy. All of the listed approaches for the treatment of migraine in childhood are discussed in detail.

Мигрень – это заболевание нервной системы, которое встречается у 7,7% детей и может дебютировать в возрасте до 3 лет. По мере взросления заболеваемость мигренью увеличивается, и среди подростков его распространенность достигает 15%. Заболевание может значимо снижать повседневную активность ребенка, успеваемость в школе. Мигрень – самая частая причина головной боли у детей и подростков, однако она далеко не всегда диагностируется; нередко пациентам с мигренью ставятся ошибочные диагнозы, назначается неэффективное лечение. Представлен эффективный подход к диагностике мигрени у детей, описаны диагностические критерии мигрени по Международной классификации головных болей 3-го пересмотра. Описаны особые расстройства в детском возрасте – эпизодические синдромы у детей, ассоциированные с мигренью. Лечение мигрени у детей включает четыре основных подхода: 1) рекомендации по образу жизни; 2) терапия для купирования приступа; 3) нелекарственные методы лечения; 4) профилактическая фармакотерапия мигрени. Подробно рассмотрены все перечисленные подходы к терапии мигрени в детском возрасте.

головная больдетидиагностикалечениемигреньподросткиheadachechildrenevaluationtreatmentmigraineadolescentsReferencesAbu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol. 2010 Dec;52(12):1088-97. doi: 10.1111/j.1469-8749.2010.03793.x. Epub 2010 Sep 28.Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol. 2010 Dec;52(12):1088-97. doi: 10.1111/j.1469-8749.2010.03793.x. Epub 2010 Sep 28.Victor TW, Hu X, Campbell JC, et al. Migraine prevalence by age and sex in the United States: a life-span study. Cephalalgia. 2010 Sep;30(9):1065-72. doi: 10.1177/0333102409355601. Epub 2010 Mar 12.Victor TW, Hu X, Campbell JC, et al. Migraine prevalence by age and sex in the United States: a life-span study. Cephalalgia. 2010 Sep;30(9):1065-72. doi: 10.1177/0333102409355601. Epub 2010 Mar 12.Greene K, Irwin SL, Gelfand AA. Pediatric Migraine: An Update. Neurol Clin. 2019 Nov;37(4):815-33. doi: 10.1016/j.ncl.2019.07.009. Epub 2019 Aug 31.Greene K, Irwin SL, Gelfand AA. Pediatric Migraine: An Update. Neurol Clin. 2019 Nov;37(4):815-33. doi: 10.1016/j.ncl.2019.07.009. Epub 2019 Aug 31.Lipton RB, Scher AI, Steiner TJ, et al. Patterns of health care utilization for migraine in England and in the United States. Neurology. 2003 Feb 11;60(3):441-8. doi: 10.1212/wnl.60.3.441Lipton RB, Scher AI, Steiner TJ, et al. Patterns of health care utilization for migraine in England and in the United States. Neurology. 2003 Feb 11;60(3):441-8. doi: 10.1212/wnl.60.3.441Ayzenberg I, Katsarava Z, Sborowski A, et al; Lifting the Burden. The prevalence of primary headache disorders in Russia: a countrywide survey. Cephalalgia. 2012 Apr;32(5):373-81. doi: 10.1177/0333102412438977. Epub 2012 Mar 6.Ayzenberg I, Katsarava Z, Sborowski A, et al; Lifting the Burden. The prevalence of primary headache disorders in Russia: a countrywide survey. Cephalalgia. 2012 Apr;32(5):373-81. doi: 10.1177/0333102412438977. Epub 2012 Mar 6.Рачин АП, Юдельсон ЯБ, Сергеев АВ. Эпидемиология хронической ежедневной головной боли у детей и подростков. Боль. 2004;2(3):27-30.Rachin AP, Yudel'son YAB, Sergeyev AV. Epidemiology of chronic daily headache in children and adolescents. Bol'. 2004;2(3):27-30 (In Russ.).Congdon PJ, Forsythe WI. Migraine in childhood: a study of 300 children. Dev Med Child Neurol. 1979;21:209-16. doi: 10.1111/j.1469-8749.1979.tb01603.xCongdon PJ, Forsythe WI. Migraine in childhood: a study of 300 children. Dev Med Child Neurol. 1979;21:209-16. doi: 10.1111/j.1469-8749.1979.tb01603.xLee LH, Olness KN. Clinical and demographic characteristics of migraine in urban children. Headache. 1997 May;37(5):269-76. doi: 10.1046/j.1526-4610.1997.3705269.xLee LH, Olness KN. Clinical and demographic characteristics of migraine in urban children. Headache. 1997 May;37(5):269-76. doi: 10.1046/j.1526-4610.1997.3705269.xLipton RB, Manack A, Ricci JA, et al. Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C-dAS). Headache. 2011 May;51(5):693-706. doi: 10.1111/j.1526-4610.2011.01885.xLipton RB, Manack A, Ricci JA, et al. Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C-dAS). Headache. 2011 May;51(5):693-706. doi: 10.1111/j.1526-4610.2011.01885.xСергеев АВ, Екушева ЕВ. Мигрень у детей. Особенности диагностики и современные возможности терапии. РМЖ. Медицинское обозрение. 2018;2(9):26-32.Sergeev AV, Ekusheva EV. Migraine in children. Diagnostics features and modern possibilities of therapy. RMZh. Meditsinskoye obozreniye = RMJ. Medical Review. 2018;2(9):26-32 (In Russ.).Arruda MA, Bigal ME. Migraine and migraine subtypes in preadolescent children: association with school performance. Neurology. 2012 Oct 30;79(18):1881-8. doi: 10.1212/WNL.0b013e318271f812Arruda MA, Bigal ME. Migraine and migraine subtypes in preadolescent children: association with school performance. Neurology. 2012 Oct 30;79(18):1881-8. doi: 10.1212/WNL.0b013e318271f812Sasmaz T, Bugdayci R, Ozge A, et al. Are parents aware of their schoolchildren's headache? Eur J Public Health. 2004 Dec;14(4):366-8. doi: 10.1093/eurpub/14.4.366Sasmaz T, Bugdayci R, Ozge A, et al. Are parents aware of their schoolchildren's headache? Eur J Public Health. 2004 Dec;14(4):366-8. doi: 10.1093/eurpub/14.4.366Сергеев АВ. Мигрень и головная боль напряжения у детей. Вопросы современной педиатрии. 2012;11(5):64-9. doi: 10.15690/vsp.v11i6.488Sergeyev AV. Migraine and tension headache in children. Voprosy sovremennoy pediatrii. 2012;11(5):64-9. doi: 10.15690/vsp.v11i6.488 (In Russ.).Скоробогатых КВ, Азимова ЮЭ. Сравнительная оценка эффективности комбинации суматриптана и декскетопрофена и монотерапии суматриптаном при лечении приступа мигрени. Неврология, нейропсихиатрия, психосоматика. 2018;10(3):42-7. doi: 10.14412/2074-2711-2018-3-42-47Skorobogatykh KV, Azimova YuE. Comparative evaluation of the efficiency of a sumatriptan/dexketoprofen combination versus sumatriptan monotherapy in the treatment of a migraine attack. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):42-7. doi: 10.14412/2074-2711-2018-3-42-47 (In Russ.).Rossi LN, Cortinovis I, Menegazzo L, et al. Behaviour during attacks and assessment of intensity in primary headaches of children and adolescents. Cephalalgia. 2006;26(2):107-12. doi: 10.1111/j.1468-2982.2005.01000.xRossi LN, Cortinovis I, Menegazzo L, et al. Behaviour during attacks and assessment of intensity in primary headaches of children and adolescents. Cephalalgia. 2006;26(2):107-12. doi: 10.1111/j.1468-2982.2005.01000.xStafstrom CE, Goldenholz SR, Dulli DA. Serial headache drawings by children with migraine: correlation with clinical headache status. J Child Neurol. 2005;20(10):809-13. doi: 10.1177/08830738050200100501Stafstrom CE, Goldenholz SR, Dulli DA. Serial headache drawings by children with migraine: correlation with clinical headache status. J Child Neurol. 2005;20(10):809-13. doi: 10.1177/08830738050200100501Головачева ВА, Пожидаев КА, Головачева АА. Когнитивные нарушения у пациентов с мигренью: причины, принципы эффективного предупреждения и лечения. Неврология, нейропсихиатрия, психосоматика. 2018;10(3):141-9. doi: 10.14412/2074-2711-2018-3-141-149Golovacheva VA, Pozhidaev KA, Golovacheva AA. Cognitive impairment in patients with migraine: causes, principles of effective prevention and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):141-9. doi: 10.14412/2074-2711-2018-3-141-149 (In Russ.).Headache Classification Committee of the International Headache Society (IHS) The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202Headache Classification Committee of the International Headache Society (IHS) The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202Popova V, Berk T. Pediatric Migraine – An Updated Review. US Neurology. 2019:15(2):68-73. doi: 10.17925/USN.2019.15.2.68Popova V, Berk T. Pediatric Migraine – An Updated Review. US Neurology. 2019:15(2):68-73. doi: 10.17925/USN.2019.15.2.68Hershey AD, Winner P, Kabbouche MA, et al. Use of the ICHD-II criteria in the diagnosis of pediatric migraine. Headache. NovDec 2005;45(10):1288-97. doi: 10.1111/j.1526-4610.2005.00260.xHershey AD, Winner P, Kabbouche MA, et al. Use of the ICHD-II criteria in the diagnosis of pediatric migraine. Headache. NovDec 2005;45(10):1288-97. doi: 10.1111/j.1526-4610.2005.00260.xMcAbee GN, Morse AM, Assadi M. Pediatric Aspects of Headache Classification in the International Classification of Headache Disorders – 3 (ICHD-3 beta version). Curr Pain Headache Rep. 2016 Jan;20(1):7. doi: 10.1007/s11916-015-0537-5McAbee GN, Morse AM, Assadi M. Pediatric Aspects of Headache Classification in the International Classification of Headache Disorders – 3 (ICHD-3 beta version). Curr Pain Headache Rep. 2016 Jan;20(1):7. doi: 10.1007/s11916-015-0537-5Youssef PE, Mack KJ. Episodic and chronic migraine in children. Dev Med Child Neurol. 2020 Jan;62(1):34-41.Youssef PE, Mack KJ. Episodic and chronic migraine in children. Dev Med Child Neurol. 2020 Jan;62(1):34-41. doi: 10.1111/dmcn.14338. Epub 2019 Aug 28.doi: 10.1111/dmcn.14338. Epub 2019 Aug 28.Gelfand AA, Reider AC, Goadsby PJ. Cranial autonomic symptoms in pediatric migraine are the rule, not the exception. Neurology. 2013 Jul 30;81(5):431-6. doi: 10.1212/WNL.0b013e31829d872a. Epub 2013 Jun 28.Gelfand AA, Reider AC, Goadsby PJ. Cranial autonomic symptoms in pediatric migraine are the rule, not the exception. Neurology. 2013 Jul 30;81(5):431-6. doi: 10.1212/WNL.0b013e31829d872a. Epub 2013 Jun 28.Hachinski VC, Porchawka J, Steele JC. Visual symptoms in the migraine syndrome. Neurology. 1973;23:570-9. doi: 10.1212/wnl.23.6.570Hachinski VC, Porchawka J, Steele JC. Visual symptoms in the migraine syndrome. Neurology. 1973;23:570-9. doi: 10.1212/wnl.23.6.570Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician. 2015 Oct 1;92(7):577-82.Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician. 2015 Oct 1;92(7):577-82.Gelfand AA, Thomas KC, Goadsby PJ. Before the headache: infant colic as an early life expression of migraine. Neurology. 2012;79(13):1392-6. doi: 10.1212/WNL.0b013e31826c1b7bGelfand AA, Thomas KC, Goadsby PJ. Before the headache: infant colic as an early life expression of migraine. Neurology.Sweney MT, Silver K, Gerard-Blanluet M, et al. Alternating hemiplegia of childhood: early characteristics and evolution of a neurodevelopmental syndrome. Pediatrics. 2009;123(3):e534-41. doi: 10.1542/peds.2008-2027;79(13):1392-6. doi: 10.1212/WNL.0b013e31826c1b7bHeinzen EL, Swoboda KJ, Hitomi Y, et al. De novo mutations in ATP1A3 cause alternating hemiplegia of childhood. Nat Genet. 2012;44(9):1030-4. doi: 10.1038/ng.2358Sweney MT, Silver K, Gerard-Blanluet M, et al. Alternating hemiplegia of childhood: early characteristics and evolution of a neurodevelopmental syndrome. Pediatrics. 2009;123(3):e534-41. doi: 10.1542/peds.2008-2027Zenkevich AS, Filatova EG, Latysheva NV. Migraine and neck pain: Mechanisms of comorbidity. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2016;8(1):29-34. doi: 10.14412/2074-2711-2016-1-29-34 (In Russ.).Heinzen EL, Swoboda KJ, Hitomi Y, et al. De novo mutations in ATP1A3 cause alternating hemiplegia of childhood. Nat Genet. 2012;44(9):1030-4. doi: 10.1038/ng.2358Paruthi S, Brooks LJ, D'Ambrosio C, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016 Jun 15;12(6):785-6. doi: 10.5664/jcsm.5866Зенкевич АС, Филатова ЕГ, Латышева НВ. Мигрень и боль в шее: механизмы коморбидности. Неврология, нейропсихиатрия, психосоматика. 2016;8(1):29-34. doi: 10.14412/2074-2711-2016-1-29-34Figueiro MG, Bierman A, Rea MS. A train of blue light pulses delivered through closed eyelids suppresses melatonin and phase shifts the human circadian system. Nat Sci Sleep. 2013 Oct 4;5:133-41. doi: 10.2147/NSS.S52203. eCollection 2013.Paruthi S, Brooks LJ, D'Ambrosio C, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016 Jun 15;12(6):785-6. doi: 10.5664/jcsm.5866Figueiro MG, Plitnick B, Rea MS. Pulsing blue light through closed eyelids: effects on acute melatonin suppression and phase shifting of dim light melatonin onset. Nat Sci Sleep. 2014 Dec 2;6:149-56. doi: 10.2147/NSS.S73856. eCollection 2014.Figueiro MG, Bierman A, Rea MS. A train of blue light pulses delivered through closed eyelids suppresses melatonin and phase shifts the human circadian system. Nat Sci Sleep. 2013 Oct 4;5:133-41. doi: 10.2147/NSS.S52203. eCollection 2013.Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Prev Med Rep. 2018 Oct 18;12:271-83. doi: 10.1016/j.pmedr.2018.10.003. eCollection 2018 Dec.Figueiro MG, Plitnick B, Rea MS. Pulsing blue light through closed eyelids: effects on acute melatonin suppression and phase shifting of dim light melatonin onset. Nat Sci Sleep. 2014 Dec 2;6:149-56. doi: 10.2147/NSS.S73856. eCollection 2014.Maras D, Flament MF, Murray M, et al. Screen time is associated with depression and anxiety in Canadian youth. Prev Med. 2015 Apr;73:133-8. doi: 10.1016/j.ypmed.2015.01.029. Epub 2015 Feb 2.Twenge JM, Campbell WK. Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Prev Med Rep. 2018 Oct 18;12:271-83. doi: 10.1016/j.pmedr.2018.10.003. eCollection 2018 Dec.Straube A, Heinen F, Ebinger F, von Kries R. Headache in school children: prevalence and risk factors. Dtsch Arztebl Int. 2013 Nov 29;110(48):811-8. doi: 10.3238/arztebl.2013.0811Maras D, Flament MF, Murray M, et al. Screen time is associated with depression and anxiety in Canadian youth. Prev Med. 2015 Apr;73:133-8. doi: 10.1016/j.ypmed.2015.01.029. Epub 2015 Feb 2.Orr SL, Potter BK, Ma J, Colman I. Migraine and mental health in a populationbased sample of adolescents. Can J Neurol Sci. 2017 Jan;44(1):44-50. doi: 10.1017/cjn.2016.402. Epub 2016 Oct 24.Straube A, Heinen F, Ebinger F, von Kries R. Headache in school children: prevalence and risk factors. Dtsch Arztebl Int. 2013 Nov 29;110(48):811-8. doi: 10.3238/arztebl.2013.0811Lewis DW, Kellstein D, Dahl G, et al. Children's ibuprofen suspension for the acute treatment of pediatric migraine. Headache. 2002 Sep;42(8):780-6. doi: 10.1046/j.1526-4610.2002.02180.xOrr SL, Potter BK, Ma J, Colman I. Migraine and mental health in a populationbased sample of adolescents. Can J Neurol Sci. 2017 Jan;44(1):44-50. doi: 10.1017/cjn.2016.402. Epub 2016 Oct 24.Oskoui M, Pringsheim T, Holler-Managan Y, et al. Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019 Sep 10;93(11):487-99. doi: 10.1212/WNL.0000000000008095. Epub 2019 Aug 14.Lewis DW, Kellstein D, Dahl G, et al. Children's ibuprofen suspension for the acute treatment of pediatric migraine. Headache. 2002 Sep;42(8):780-6. doi: 10.1046/j.1526-4610.2002.02180.xRicher L, Billinghurst L, Linsdell MA, et al. Drugs for the acute treatment of migraine in children and adolescents. Cochrane Database Syst Rev. 2016 Apr 19;4(4):CD005220. doi: 10.1002/14651858.CD005220.pub2Oskoui M, Pringsheim T, Holler-Managan Y, et al. Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019 Sep 10;93(11):487-99. doi: 10.1212/WNL.0000000000008095. Epub 2019 Aug 14.Kanis JM, Timm NL. Chlorpromazine for the treatment of migraine in a pediatric emergency department. Headache. 2014 Feb;54(2):335-42. doi: 10.1111/head.12255. Epub 2013 Oct 29.Richer L, Billinghurst L, Linsdell MA, et al. Drugs for the acute treatment of migraine in children and adolescents. Cochrane Database Syst Rev. 2016 Apr 19;4(4):CD005220. doi: 10.1002/14651858.CD005220.pub2Patniyot IR, Gelfand AA. Acute treatment therapies for pediatric migraine: a qualitative systematic review. Headache. 2016 Jan;56(1):49-70. doi: 10.1111/head.12746Kanis JM, Timm NL. Chlorpromazine for the treatment of migraine in a pediatric emergency department. Headache. 2014 Feb;54(2):335-42. doi: 10.1111/head.12255. Epub 2013 Oct 29.Powers SW, Kashikar-Zuck SM, Allen JR, et al. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA. 2013 Dec 25;310(24):2622-30. doi: 10.1001/jama.2013.282533Patniyot IR, Gelfand AA. Acute treatment therapies for pediatric migraine: a qualitative systematic review. Headache. 2016 Jan;56(1):49-70. doi: 10.1111/head.12746Oskoui M, Pringsheim T, Billinghurst L, et al. Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019 Sep 10;93(11):500-9. doi: 10.1212/WNL.0000000000008105. Epub 2019 Aug 14.Powers SW, Kashikar-Zuck SM, Allen JR, et al. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA. 2013 Dec 25;310(24):2622-30. doi: 10.1001/jama.2013.282533Szperka CL, VanderPluym J, Orr SL, et al. Recommendations on the Use of Anti-CGRP Monoclonal Antibodies in Children and Adolescents. Headache. 2018 Nov;58(10):1658-69. doi: 10.1111/head.13414. Epub 2018 Oct 15.Oskoui M, Pringsheim T, Billinghurst L, et al. Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019 Sep 10;93(11):500-9. doi: 10.1212/WNL.0000000000008105. Epub 2019 Aug 14.Oskoui M, Pringsheim T, Billinghurst L, et al. Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019 Sep 10;93(11):500-9. doi: 10.1212/WNL.0000000000008105. Epub 2019 Aug 14.Szperka CL, VanderPluym J, Orr SL, et al. Recommendations on the Use of Anti-CGRP Monoclonal Antibodies in Children and Adolescents. Headache. 2018 Nov;58(10):1658-69. doi: 10.1111/head.13414. Epub 2018 Oct 15.Szperka CL, VanderPluym J, Orr SL, et al. Recommendations on the Use of Anti-CGRP Monoclonal Antibodies in Children and Adolescents. Headache. 2018 Nov;58(10):1658-69. doi: 10.1111/head.13414. Epub 2018 Oct 15.

The authors declare that there are no conflicts of interest present.