Diagnosis of Migraine in the Pediatric Emergency Department

Trottier, Evelyne D; Bailey, Benoît; Lucas, Nathalie; Lortie, Anne

doi:10.1016/j.pediatrneurol.2013.03.003

Cited by 24 publications

(18 citation statements)

References 14 publications

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“…However, it is very difficult to apply these criteria in regime of emergency. First of all, the diagnosis of migraine requires five distinct headache events over time, but most children consulting in the ED present with their first episode [14,23]. This question has been recently debated in a pediatric prospective study showing that less than half of the patients with confirmed migraine by a neurologist fulfilled the criteria for migraine episodes [23].…”

Section: Acute Recurrent Headachementioning

confidence: 99%

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Headache as an Emergency in Children and Adolescents

Papetti

Capuano

Tarantino

et al. 2015

Curr Pain Headache Rep

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Pediatric and adolescence headache is one of the most common causes of access in emergency departments (ED). Primary headache and headache secondary to self-limited conditions are the majority of cases. Secondary life-threatening headaches are less frequent and may be recognized by a careful history and physical examination. The primary objective for ED physicians is to recognize the serious life-threatening conditions requiring immediate medical care among the wide spectrum of headache diagnoses.

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Section: Acute Recurrent Headachementioning

confidence: 99%

“…The last version of ICHD criteria (III edition, beta) still requires at least five attacks for the diagnosis of migraine [20]. In further studies, the minimal number of attacks required to reach better sensitivity and specificity should also be evaluated [23].…”

Section: Acute Recurrent Headachementioning

confidence: 99%

Headache as an Emergency in Children and Adolescents

Papetti

Capuano

Tarantino

et al. 2015

Curr Pain Headache Rep

View full text Add to dashboard Cite

show abstract

“…The reliance on recurrent attacks as a diagnostic criterion using the IHS definition (Table 1) 25 †Recurrent attacks may not be required for ED diagnosis. 26 ‡Not to include posterior location. 25 †Recurrent attacks may not be required for ED diagnosis.…”

Section: Diagnosismentioning

confidence: 99%

“…25 †Recurrent attacks may not be required for ED diagnosis. 26 in the emergency department (ED) setting as patients with new onset migraine headaches may present during their first attack. The Irma Criteria, which are the same as the IHS criteria, but eliminate the requirement for recurrent episodes, may be more sensitive in the ED, as suggested by a study by Trottier et al 26 In this study, the authors found that 45% of pediatric patients clinically diagnosed with migraine were confirmed by a pediatric neurologist within 3 months to meet the IHS diagnostic criteria for migraine headache; however, when they applied new diagnostic criteria (the "Irma criteria"), 86% of this group would have fulfilled criteria in the ED.…”

Section: Diagnosismentioning

confidence: 99%

Pediatric Migraine: Abortive Management in the Emergency Department

2013

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Studies suggest that headache accounts for approximately 1% of pediatric emergency department (ED) visits. ED physicians must distinguish between primary headaches, such as a tension or migraine, and secondary headaches caused by systemic disease including neoplasm, infection, or intracranial hemorrhage. A recent study found that 40% of children presenting to the ED with headache were diagnosed with a primary headache, and 75% of these were migraine. Once the diagnosis of migraine has been made, the ED physician is faced with the challenge of determining appropriate abortive treatment. This review summarizes the most recent literature on pediatric migraine with an emphasis on diagnosis and abortive treatment in the ED.

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“…Some studies have described trends in visits to the pediatric ED for headache or have characterized the population of pediatric patients visiting acute settings with migraine beyond basic demographics such as age and sex. Few of these studies have used the International Classification of Headache Disorders criteria (ICHD), the accepted gold standard for migraine diagnosis, to ascertain migraine cases . There is an opportunity to better characterize this patient population using data from the infusion center setting, as case ascertainment in this setting is likely to be more accurate than in the ED.…”

Section: Introductionmentioning

confidence: 99%