Treating Migraine in Children and Adolescents

Abstract

To the Editor We read with interest the Editorial by Zernikow¹ regarding the meta-analysis² published in JAMA Pediatrics on pharmacologic migraine prevention in children and adolescents. As experts, we agree with Zernikow that “migraine is not just a headache”¹ and thus struggle with the advice that the “…cornerstone of treatment… is pain education.”¹ Rather, it is education based on the underlying problem, which is very rarely education just about pain. Moreover, we agree that “globally, migraine experts recommend the regular use of pharmacologic prophylactic treatment in childhood.”¹ However, this is where our agreement ends.