OUR BLOG

A study was conducted to describe the consulting behavior and clinical outcomes of children, aged 5 to 17, presenting with headache in primary care. These headaches were described as migraine, tension-type headache, cluster headache or headache with no further descriptor.

The impact of headache on the quality of life of sufferers is significant both at school and at home. Headache has a high risk of persisting into adulthood. The needs of adult headache sufferers are often unmet, and the situation may be worse in the pediatric population, where sufferers are less likely to articulate their problem or seek help. Little is understood about current practice in managing headache in children.

The incidence of brain tumor, a major concern for parents, patients and practitioners, is very low, particularly if headache is the primary diagnosis. However, children with headache have higher levels of anxiety and depression and demonstrate different behavioral characteristics when compare with children not having headache.

Cases receiving a diagnosis of migraine were examined for specific migraine treatment in subsequent year. Drugs were identified that were most likely to be used exclusively for the management of migraine. For the acute attack nasal sumatriptan is the only licensed triptan in the age groups studied.

It is important to identify, diagnose and treat the headache once more serious causes have been excluded. Research is needed to explore why General Practitioners find difficulty in diagnosing headaches, particularly in the younger age group, and to develop strategies to facilitate diagnosis. GPs should be encouraged to make a positive diagnosis in their headache patients as the first step to successful management.

A study in nearly 70,000 pregnant women has found no link between migraine drugs called triptans and the risk of birth defects.

Triptans are among the most powerful drugs used for migraine; others include aspirin, Excedrin, and ibuprofen.

The study, conducted by Katerina Nezvalova-Henriksen of the University of Oslo in Norway, noted that while as many as three in 10 women may develop migraines during their childbearing years, women often shy away from using such drugs during pregnancy because of safety concerns.

The study found that the percentage of birth defects was the same for those who took triptans during pregnancy as those who were not migraine sufferers: 5 percent.

The authors of the study noted, “While it is important to exert caution when using any medications during pregnancy, this study indicates that pregnant women can either start or continue taking triptans without “any major risk” of miscarriage, premature delivery, or other bad outcomes”.

However, the researchers did find that women who used triptans in their second or third trimester were more likely to develop a condition called atonic uterus, in which the uterus fails to contract back to its normal size after delivery. They were also more likely to lose significant amounts of blood during labor and delivery.

Many women who suffer from migraines will experience improvements in their symptoms after their first trimester, Nezvalova-Henriksen and her team note, yet those whose symptoms don’t improve by then aren’t likely to get better.

“Although the findings are reassuring, confirmation in independent studies is warranted,” the researchers conclude.