Pediatric migraine

Migraine represents a wide spectrum of episodic clinical entities in childhood and adolescence. Attacks of frontal or bitemporal, pounding, nauseating headache lasting 1 to 48 hours represent the most common manifestation of migraine, but a curious subset of focal neurologic disturbances also may represent migraine. The philosophy of treatment now embraces a balanced approach that includes both biobehavioral interventions and pharmacologic measures, and decisions regarding treatment are being based on the disability produced by the headaches. A growing body of controlled pediatric data regarding the acute and preventive agents for treatment of childhood migraines is emerging, thereby lessening clinicians' dependence on extrapolated adult data. In the near future, we anticipate additional advances in understanding the neurobiology of migraine that should translate to improved care of affected pediatric patients.