Preventive Treatment Options for Childhood Migraines

Unlike in adults, preventive treatment for migraines in children is generally recommended only when the frequency and severity of headaches significantly impact the child's daily life or lead to excessive use of acute medications. When necessary, preventive strategies can be considered to reduce the occurrence and intensity of migraine episodes.

Non-Pharmacological Approaches

Sufficient sleep is crucial for children suffering from migraines. Ensuring a consistent sleep schedule with 8 to 10 hours of rest each night can help regulate brain activity and reduce the likelihood of migraine attacks.

Relaxation techniques such as guided imagery, deep breathing exercises, and mindfulness can also be beneficial. These methods help reduce stress, which is a common trigger for migraines in children.

Biofeedback therapy has shown promise in managing migraines. This technique teaches children how to control physiological responses like muscle tension and heart rate, which can contribute to headache onset.

Pharmacological Treatments

When non-drug therapies fail to provide relief, preventive medications may be considered. Among these, flunarizine has been supported by clinical evidence as an effective option for children. Additionally, small-scale studies suggest that antiepileptic drugs such as low-dose levetiracetam and gabapentin may also offer preventive benefits.

Duration of Preventive Therapy

The appropriate duration of preventive treatment in children remains a topic of debate among healthcare professionals. Some experts recommend continuing therapy during the school year, when academic stress and irregular sleep patterns may increase migraine risk, and tapering off during school breaks or holidays.

Others suggest that a trial period of 6 to 8 weeks may be sufficient to assess the effectiveness of the treatment, after which a gradual discontinuation plan can be considered, depending on the child's response and overall improvement.