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Abstract Details

Management of Childhood Migraine by Headache Specialist versus Non-Headache Specialists
Headache
P4 - Poster Session 4 (5:30 PM-6:30 PM)
7-006
This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuro-imaging, and short-term outcomes are compared in children treated by the two groups of physicians.
Migraine is a common disorder in children. As medicine continues to become specialized, there is evidence that children with certain conditions, who are evaluated by specialists have better outcomes.
A retrospective cohort study was conducted utilizing the electronic medical records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children’s hospital from 2016-2018.
Of the 849 patients that met the study criteria, 469 were classified as having chronic migraine or high-frequency episodic migraine and were followed up on at least one occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5-HT agonists (“triptans”) for migraine management in 56.7% of cases compared to non-headache specialists who prescribed them in 28.7% of cases (p <0.001). Of the children with chronic migraine, the headache specialist evaluated 135 patients while the non-headache specialists treated 334 children. Non-headache specialists prescribed prophylaxis in the form of natural supplements more frequently (63.8% of cases) compared to the headache specialist (38.5% of children) (p<0.001). Contrarily, prophylaxis with prescription drugs was utilized more often by the headache specialist (66.7%) than non-headache specialists (37.4%) (p<0.001).
Imaging appears to be commonly recommended by both headache specialists and non-headache specialists in children with migraine. The headache specialist was more likely to use triptans as rescue medications for pediatric migraine. Outcomes in the short term were not statistically different whether children were being managed by the headache specialist or the non-headache specialists.
Authors/Disclosures
Kelly Valentini
PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Lalitha Sivaswamy, MD Dr. Sivaswamy has nothing to disclose.