Your patient has passed the next step, by graduating from high school. They have chosen their next path- going to college. They are so pleased to tell you all about it, and you are so proud of them. This is also a time of both positive and negative stress. Perhaps high school was really hard … Continue reading Thriving with college accommodations
There are times when all your patient’s rescue strategies just are not working. The migraine episode is going on and on for several days, or it is worse than usual, or they are vomiting and getting dehydrated. Your patient has taken their usual rescue medications, perhaps done their usual thing when the rescue does not … Continue reading Visiting the ED or Urgent care
I did my first post about Botox for teens under 18 in July 2019, 3 years ago! My intention was to review our data and prepare for publication a paper supporting the use of Botox for those under age 18. The more academic publications there are available, the better to make the case with insurance … Continue reading Update on Botox for teens under 18
When I first covered the anti-CGRP medications, it was 2019, just 1 year after they had come out. Since then, we have much gained more exposure to these medications, though none are approved by the FDA for those under age 18 yet. We get asked all the time about these medications, and while they do … Continue reading Revisiting the ‘new’ migraine prevention medications
In this post, I revisit the prescribing a daily medication for migraine prophylaxis, the standard medications for those under age 18. I use one migraine/week as a benchmark for considering a daily preventive medication. Here’s some good information on the basic daily medications that pediatric primary care providers could start for their patients with frequent … Continue reading Revisiting pediatric migraine: preventive medications, part 1
Primary preventive measures to reduce migraine, such as the healthy headache lifestyle, are key to keeping migraine frequency to a minimum. But even though your patient is really working hard with the multidisciplinary approach, your patient is still having frequent migraines which significantly impact their functioning. When do you consider adding a daily medication to … Continue reading Revisiting migraine: supplements
My last posts have focused on migraine abortives and analgesia for kids with migraine. Here I will continue to review medications and strategies for rescue, focusing on adjuvants and combination medications. These medications are the 3rd leg of the plan which are used to treat migraine. . There are several medications that are used either … Continue reading Revisiting migraines part 4: adjuvant medications and combination therapies
My last post focused on the migraine abortive medications for kids with migraine. Here I will continue to review medications and strategies for rescue, focusing on analgesia. There are 3 different types of medications that are important in migraine rescue therapy: migraine abortive, analgesia, and adjuncts. Analgesic medications are those used to reduce or eliminate … Continue reading Revisiting migraines part 3: analgesia
I realized today that it has been almost 4 years ago since I started writing regularly on this blog. Many things have changed, including medications, treatments and my knowledge about headaches. In the interim, I even managed to write a practical manual about caring for kids and teens with headaches. Much of the new information … Continue reading Revisiting pediatric migraine, part 1
In part 1 of this post, pain and psychiatric issues often travel together. Chronic headache pain can lead to long-lasting psychological distress, and depression and anxiety increase the perception of both acute and chronic pain. They are intimately connected. This post will continue the discussion about psychiatric co-morbidities and headache, focusing on psychopharmacology. What is … Continue reading Headaches and psychiatric co-morbidities, part 2
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