Clinical Studies at American Headache Society 59th Annual Scientific Meeting Show Gap in Understanding of Migraine Diagnosis and Treatment in Pediatric Patients
[MOUNT ROYAL, N.J., June 7, 2017] – At the American Headache Society (AHS)’s 59th Annual Scientific Meeting, leading migraine experts are presenting four clinical studies that deepen the understanding of migraine in children and adolescents, while also demonstrating that further research is needed on multiple fronts. Data highlighted show that children and young adults with migraine experience a range of symptoms not usually considered typical in pediatric migraine, and that their desired outcomes contrast with how healthcare providers view successful results. Additionally, another study spotlighted at the meeting demonstrates that medication used for adults with migraine has been shown to be effective in adolescent patients.
Migraine is the most common cause of disabling headache in children. As children can experience severe headaches and not be able to describe what they are feeling, they may be living with undiagnosed migraine and symptoms that may cause them to miss class, struggle with schoolwork and experience social isolation.
“It is critical that we find better ways to help children and adolescents living with the disabling impact of migraine during the most formative years of their lives,” said Peter Goadsby, MD, PhD, FAHS, AHS Scientific Program Committee Chair, Professor of Neurology, King’s College London and University of California, San Francisco, and Director, NIHR-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, London. “While data presented at the AHS Annual Scientific Meeting further illuminate our understanding of pediatric migraine, it also shows that current benchmarks used to diagnose and treat this patient population are insufficient.”
Re-evaluation Needed for Diagnostic Criteria Used for Pediatric Migraine Patients
A study titled “Mapping Pain in Pediatric Migraine” shows that children and young adults experience migraine differently from current diagnostic criteria outlined in the International Classification of Headache Disorders 3rd Edition (beta version) (ICHD-3), which categorizes migraine based on symptoms typically reported in adults. It was conducted at Boston Children’s Hospital and investigated the criteria from the ICHD-3 and its applicability toward diagnosing pediatric migraine patients. Children and young adults aged 7-26 years old answered a questionnaire to determine where they felt pain, and mapped the progression of their headaches from beginning to end. The results demonstrate differences in migraine presentation between pediatric and adult patients, which show a need to reevaluate the ICHD diagnostic criteria to address the unique symptoms of this patient population.
A study titled “Premonitory Symptoms in Pediatric Migraine: A Prospective Study” shows that researchers are beginning to understand pediatric migraine and premonitory symptoms, which often signal that a migraine is beginning and can help with management of acute headache attacks. The study captured data from 207 pediatric migraine patients aged 5-18 years and evaluated the six most common premonitory signs, which are yawning, neck stiffness, fatigue, food cravings, increased urination and mood changes. Nearly 37% reported premonitory signs with their migraine, with the most common being fatigue and mood changes. These signs were slightly more prevalent in girls and younger children, compared to boys and adolescents.
Chasm Between Acceptable Outcomes for Clinicians and their Pediatric Patients and Parents
A study, “Pediatric Patient and Parent Goals and Preferences for Preventive Headache Treatment,” was conducted at five academic headache centers and evaluated the goals of preventive therapy. Based on medical literature, clinicians have a goal of 50% reduction in migraine frequency or a reduction to one headache per week. However, many patients and parents expect headaches to either stop or decrease to no more than two or three migraines per month. Additionally, they are willing to try many standard therapies to achieve these outcomes and expect minimal side effects. Given these discrepancies, expectations about preventive treatments should be discussed openly between clinicians, patients and parents.
Treatment for Adolescent Migraine Found Effective
While acute migraine is common in adolescents; effective therapies for this patient group are limited. “Efficacy of Zolmitriptan Nasal Spray for the Treatment of Acute Migraine in Adolescents: Subgroup Analysis by Age” analyzed the therapy’s efficacy in adolescents with a migraine diagnosis. A total of 1,653 patients were enrolled in the study, which found that zolmitriptan 5mg significantly improved the pain-free status at two hours compared to placebo in adolescents.
Migraine is a major disabling neurological disease that affects more than 36 million men, women and children in the United States. The disease impacts one in four households, one in five women, one in 16 men and one in 11 children in the United States. Globally, migraine is the sixth highest cause of years of life lost due to disability. Individuals who experience migraine have symptoms that include nausea, sensitivity to light and/or odors, skin sensitivity, fatigue, mood change, dizziness, difficulty concentrating, neck pain and changes in vision, including seeing spots, stars, lines, flashing lights and zigzag lines. The risk of other serious diseases is significantly higher in those with migraine, including stroke, epilepsy, depression, anxiety and chronic pain. Despite this, only one of every three people talk with a doctor about their migraine attacks and of those, only half get the right diagnosis. There is also a massive shortage of specialists focusing on migraine, with one specialist for every 65,000 individuals living with migraine, which worsens the problem.
About the American Headache Society
The American Headache Society (AHS) is a professional society of health care providers dedicated to the study and treatment of headache and face pain. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders. Educating physicians, health professionals and the public and encouraging scientific research are the primary functions of this organization. AHS activities include an annual scientific meeting, a comprehensive headache symposium, regional symposia for neurologists and family practice physicians, and publication of the journal Headache. More information can be found at www.americanheadachesociety.org. In 2010 AHS founded the American Migraine Foundation (AMF) to provide access to information and resources for individuals living with migraine, as well as their loved ones. AMF is a non-profit organization dedicated to the advancement of research and awareness surrounding migraine. Patients can learn more, find help and get connected by visiting www.americanmigrainefoundation.org.
CONTACT: Amra Maynard, Amra.Maynard@inventivhealth.com, +1 212 845 5625 and +1 917 302 2702