A case of Pediatric migraine treated with multidisciplinary approach.

Abstract

Migraine is relatively common in all age group with a prevalence of 9% in pediatric population.50% of these children continue to have migraine in adulthood. Various trigger factors for migraine have been identified like stress, irregular dietary and sleep habits, lack of physical exercise and excess use of screen like video games and mobile phone.

Management of migraine requires comprehensive approach which includes Pharmacological treatment, lifestyle changes and parental education.

We report a case of 15-year-old boy who presented with history of unilateral headache of mod to severe intensity since one year. Frequency of headache initially was once in month which gradually increased to 2-3 episodes/month. Almost all episodes were associated with nausea, watering from eyes, irritability and difficulty in concentration in studies.

Patient reported precipitation of headache episodes with long hours of studies, irregular sleeping and dietary habits and increased stress levels due to approaching board exams. Ophthalmic and neurological examination was normal.

Patient was started on Amitriptyline 10 mg night dose and Propranolol 20 mg single night dose. Tab Naproxen 250 mg was advised on as needed basis for aborting acute attack. Along with this patient and Parents were counseled regarding following regular dietary habits, moderate exercise and maintaining sleep schedule. Patient was followed up fortnightly and at 3months follow up patient reported reduced frequency of headache and increased academic performance.

Thus our case emphasis the effective role of Tricyclic antidepressants, Betablockers and adaption of healthy lifestyle.