Clinician's Manual - Treatment of Pediatric Migraine - download pdf or read online
By Donald Lewis
Migraine is a debilitating affliction, it truly is crucial that it really is clinically determined correctly and quickly in sufferers. This booklet covers, in-depth, the major diagnostic standards and coverings that pediatricians and different basic care prone has to be conscious of on the way to deal with pediatric migraine effectively.
• Written by means of knowledgeable just about pediatric migraine/headache
• A refresher for GPs and health center medical professionals with sensible diagnostic and remedy advice
• stories medical advancements and guidance, and areas them into daily medical practice
• Stresses the significance of early intervention, cures and sufferer schooling
• Concise yet comprehensive
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Extra info for Clinician's Manual - Treatment of Pediatric Migraine
Hydration is often inadequate in children with migraine, so 4–5 extra glasses of water (not soda) per day can solve that problem. The role of diet remains controversial . Somewhere between 7–44% of patients will report that a particular food or drink can precipitate a migraine attack [50,51]. In children, the principal dietary triggers were cheese, chocolate, and citrus fruits. Wholesale dietary elimination of a list of foods is, however, not recommended. Elimination diets are excessive and set the stage for a battleground at home when parents attempt to enforce a restrictive diet upon an unwilling, resistant adolescent.
Diagnostic criteria for migraine with aura are shown in Figure 8. Approximately 15–30% of children and adolescents with migraine will report visual disturbances, distortions, or obscurations before, or as, the headache begins. The visual symptoms begin gradually and last for several minutes (typical aura). The most frequent forms are binocular visual impairment with scotoma (77%), distortion or hallucinations (16%), monocular visual impairment or scotoma (7%) . Formed illusions (eg spots, balloons, colors, rainbows) or other bizarre visual distortions such as macropsia or metamorphopsia, the “Alice in Wonderland” syndrome are infrequently reported.
The doses may be gradually elevated to twice or even three times a day schedules, but, in my experience, most children become too sedated at doses much higher than 4–8 mg/day. 7 headaches/month with doses ranging between 2–6 mg given at bedtime or divided twice a day. A positive response rate, defined as an overall favorable decrease in headache frequency and intensity plus acceptability of the agent, was noted in 83% (n=30). Common side effects included sedation and increased appetite . Dosing schedules can vary widely from single bedtime schedules to tid regimens.