Helping Kids & Teens Manage Migraine
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Key Questions
- How might migraine present differently in youth versus adulthood?
- Is migraine commonly underdiagnosed in children and adolescents, and what are the challenges in diagnosis?
- Why is early and effective treatment important for each migraine attack?
- What first-line treatments are recommended for a migraine attack?
- What is important for caregivers to know about the safety of triptans?
- What nonpharmacologic options exist for prevention, and when are they considered?
- What factors guide the decision to begin daily pill-based preventive therapy?
- How is the close connection between migraine and mental health typically addressed and managed?
- What are the most crucial approaches or accommodations to help a student with migraine succeed academically?
- How can clinicians and parents help teens manage migraine without feeling defined by it?
Interview Notes
- Christina Szperka, MD, MSCE
- CHOP Pediatric Headache Program
- Facebook: @childrenshospitalofphiladelphia
- Instagram: @childrensphila
- LinkedIn: Children’s Hospital of Philadelphia
- X: @childrensphila
- Bluesky: @childrensphila.bsky.social
- Study: “Infant colic”
- Study: “Childhood and adolescent migraine prevention (CHAMP) study: A double-blinded, placebo-controlled, comparative effectiveness study of amitriptyline, topiramate and placebo in the prevention of childhood and adolescent migraine”
- Article: “Headache in Children and Adolescents”
- AHS Position Paper: “The FDA Alert on Serotonin Syndrome With Use of Triptans Combined With Selective Serotonin Reuptake Inhibitors or Selective Serotonin-Norepinephrine Reuptake Inhibitors: American Headache Society Position Paper”
- Article: “New Daily Persistent Headache: A Start with an Uncertain End”
- Migraine At School
- Section 504 Protections for Students with Migraine
- Headache Relief Guide
- Press Release: “Teva Canada Announces Approval of Expanded Indication of [Pr]AJOVY® (fremanezumab solution for subcutaneous injection), the First Anti-CGRP Preventive Treatment for Pediatric Episodic Migraine”
Treatments Mentioned
- Acetaminophen/paracetamol
- Amitriptyline (Elavil)
- Biofeedback
- CGRP small-molecule receptor antagonists (gepants)
- Cognitive behavioral therapy (CBT)
- Combined oral contraceptive pill (COC)
- Etonogestrel implant (Nexplanon)
- Exercise
- Fremanezumab (Ajovy)
- gammaCore
- Hormonal contraceptives
- Hydration
- Ibuprofen
- Intrauterine devices (IUDs)
- Magnesium
- Medroxyprogesterone acetate (Depo-Provera)
- Naproxen (Aleve)
- Nerivio
- Neuromodulation devices
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Oral contraceptive pills (OCPs)
- Progestin-only pill (POP)
- Riboflavin (vitamin B2)
- Rizatriptan (Maxalt)
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Sleep
- Topiramate (Topamax)
- Triptans
- Vitamin E
- Vitamins
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Disclaimer: The Migraine World Summit aims to bring you a variety of perspectives and expertise, free from bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan. Captions are auto-generated and may contain errors.
Christina L. Szperka, MD, MSCE, FAHS
Director, Pediatric Headache Program
Children's Hospital of Philadelphia
Christina Szperka, MD, MSCE, has been interested in the treatment of chronic pain since she was an undergraduate at Amherst College, in Amherst, Massachusetts, and focused on pediatric pain while pursuing her medical degree at Yale University School of Medicine in New Haven, Connecticut.
Dr. Szperka completed residencies in pediatrics and child neurology at the Children’s Hospital of Philadelphia (CHOP), and a fellowship in headache medicine at the Jefferson Headache Center at Thomas Jefferson University Hospital in Philadelphia. She is board certified in child neurology and headache medicine.
Dr. Szperka divides her time between patient care and projects aimed at improving the diagnosis and treatment of children with headaches across CHOP and beyond. In 2013, she was named director of the newly formed Pediatric Headache Program. She has received grants to improve clinical care of and treatment options for headache.
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