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Emergency department treatment of primary headaches in children and adolescents.
Curr Opin Pediatr. 2008 Jun; 20(3):248-54.CO

Abstract

PURPOSE OF REVIEW

Headaches in children and adolescents are common presenting complaints in emergency departments. There is wide variation among acute treatments. We sought to review options for acute emergency department management and the recent evidence supporting their use.

RECENT FINDINGS

Currently accepted diagnosis of pediatric headache is based on the International Classification of Headache Disorders-II classification system, which remains incomplete with regard to pediatric patients. In general, there is a paucity of studies evaluating acute treatment for pediatric headache, especially in the emergency department setting. Most studies use previously diagnosed patients with migraines as their subjects. Recent additions to the literature are mostly reviews in nature or pertain to the evaluation of triptan use in adolescents. No articles evaluate treatment of tension-type headaches.

SUMMARY

Further research is needed on therapies targeted toward children and adolescents with headache subtypes other than migraine, including those without a previous diagnosis. While little evidence exists, most authors agree with an initial trial of ibuprofen followed by sumatriptan nasal spray for children over 12 years of age for those with persistent symptoms. Antiemetics remain an option for those with nausea and/or vomiting as a prominent feature of their illness. Other treatments such as ketorolac are still being investigated in children.

Authors+Show Affiliations

Division of Emergency Medicine, Children's National Medical Center, Washington, DC 20010, USA. dmwalker@cnmc.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18475091

Citation

Walker, David M., and Stephen J. Teach. "Emergency Department Treatment of Primary Headaches in Children and Adolescents." Current Opinion in Pediatrics, vol. 20, no. 3, 2008, pp. 248-54.
Walker DM, Teach SJ. Emergency department treatment of primary headaches in children and adolescents. Curr Opin Pediatr. 2008;20(3):248-54.
Walker, D. M., & Teach, S. J. (2008). Emergency department treatment of primary headaches in children and adolescents. Current Opinion in Pediatrics, 20(3), 248-54. https://doi.org/10.1097/MOP.0b013e3282ff6308
Walker DM, Teach SJ. Emergency Department Treatment of Primary Headaches in Children and Adolescents. Curr Opin Pediatr. 2008;20(3):248-54. PubMed PMID: 18475091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergency department treatment of primary headaches in children and adolescents. AU - Walker,David M, AU - Teach,Stephen J, PY - 2008/5/14/pubmed PY - 2008/8/2/medline PY - 2008/5/14/entrez SP - 248 EP - 54 JF - Current opinion in pediatrics JO - Curr Opin Pediatr VL - 20 IS - 3 N2 - PURPOSE OF REVIEW: Headaches in children and adolescents are common presenting complaints in emergency departments. There is wide variation among acute treatments. We sought to review options for acute emergency department management and the recent evidence supporting their use. RECENT FINDINGS: Currently accepted diagnosis of pediatric headache is based on the International Classification of Headache Disorders-II classification system, which remains incomplete with regard to pediatric patients. In general, there is a paucity of studies evaluating acute treatment for pediatric headache, especially in the emergency department setting. Most studies use previously diagnosed patients with migraines as their subjects. Recent additions to the literature are mostly reviews in nature or pertain to the evaluation of triptan use in adolescents. No articles evaluate treatment of tension-type headaches. SUMMARY: Further research is needed on therapies targeted toward children and adolescents with headache subtypes other than migraine, including those without a previous diagnosis. While little evidence exists, most authors agree with an initial trial of ibuprofen followed by sumatriptan nasal spray for children over 12 years of age for those with persistent symptoms. Antiemetics remain an option for those with nausea and/or vomiting as a prominent feature of their illness. Other treatments such as ketorolac are still being investigated in children. SN - 1531-698X UR - https://www.unboundmedicine.com/medline/citation/18475091/Emergency_department_treatment_of_primary_headaches_in_children_and_adolescents_ L2 - https://doi.org/10.1097/MOP.0b013e3282ff6308 DB - PRIME DP - Unbound Medicine ER -