THERAPEUTIC APPROACHES TO MIGRAINE IN CHILDREN AND ADOLESCENTS: A SYSTEMATIC REVIEW
Background: migraine is classified as a common primary headache disorder. It is important among children and adolescents due to its high prevalence in these populations, mainly during school age and adolescence. The treatment of migraine in these populations aims to ensure rapid relief of the headache and minimal side effects.
Objective: critical analysis of articles about pharmacological and non-pharmacological treatments of migraine in children and adolescents.
Methods: in this systematic review articles were researched in the Medline (PubMed) database. The inclusion criteria applied were: (1) Population of children and adolescents aged 0 - 18 years; (2) Articles in English and Portuguese; (3) Articles about treatment; (4) Clinical trials and Randomized Clinical Trials. The research was conducted in July 2019.
Results: a total of 634 articles were rescued. Of these, 265 were selected by title. After reading the abstracts, 33 articles were selected and 14 were included in the analysis of this systematic review. Among pharmacological options, several drugs were analyzed: Almotriptan showed significant improvement after 2 hours for 15-17 years, but didn’t show significant improvement for 12-14 years. On the other hand, Rizatriptan was effective in doses of 5 and 10mg. The association of Sumatriptan with Naproxen sodium was satisfactory in 2 articles included in this review with three different doses: 10 / 60mg, 30 / 180mg, 85 / 500mg. Articles were also found reporting the use of Sumatriptan nasal spray (5mg and 10mg), with improvement in specific doses depending on age. The use of Sumatriptan tablets, Zolmitriptan nasal spray and Eletriptan proved to be insignificant. Among the non-pharmacological approaches, autogenic training with thermal feedback reported a significant decrease in the duration of migraine episodes at three different times: at the end of treatment, after 1 month and after 6 months. The technique of compression of superficial temporal arteries by a device was effective after 3 to 5 minutes. And falling asleep as a treatment for migraine also showed a significant improvement.
Conclusion: among pharmacological treatments, the triptan class was the one addressed in all articles included. However, not all drugs were effective. Medicines such as Almotriptan, Rizatriptan, Sumatriptan nasal spray and Sumatriptan associated with Naproxen sodium were effective. However, Sumatriptan administered orally, Eletriptan and Zolmitriptan nasal spray did not demonstrate therapeutic efficacy in the studied population. On the other hand, the three non-pharmacological approaches evaluated in this review (autogenic treatment with thermal feedback, compression of superficial temporal arteries by a device and falling asleep) proved to be effective.
Keywords: Migraine, Pediatric, Adolescents, Children, Headache.
O contato com a Comissão Científica pode ser rezalizado através do e-mail:
cientifico.comau@fcm.unicamp.br
Ferramenta completa de submissão, avaliação e publicação de anais para eventos científicos.
