engleski

Topiramate in the treatment of migraine headache in children

Migraine is a common disease in children with prevalence of 14-28% among adolescents. According to IHS criteria, the diagnosis of migraine is established if the child had at least 5 attacks of headache lasting 2-48 hours, with unilateral, pulsating, moderate or intensive pain wich is aggravated by daily activities, and accompanied by photofobia, phonophobia and vomitting. The preventive treatment also includes anticonvulsive drug – Topiramate. Topiramate inhibits Na+ and Ca++ channels, increases influx of Cl- which is induced by GABA and reduces neuronal excitabillity by blockage of glutamate excitation transmission. Topiramate acts through AMPA, not through NMDA receptors. According to recent studies, Topiramate is efficient in profilactic treatment of migraine in children. The best toleration and the lowest rate of Topiramate side effects are achieved by dosage of 100 mg daily. The responder rate of Topiramate in children id about 54%.Topiramate is indicated for migraine treatment in children when conventional treatment is unsuccessful. The titration has to be gradual, and the best effect is observed with 100 mg daily dose. Positive treatment effect is better in migraine with aura compared to migraine without aura. Topiramate treatment has more advantages compared to other antiepileptic and antimigraine drug treatment. The most recent studies though, showed that profilactic treatment of migraine is not as effective in clinical trials, and untill now, there was no medication which would be superior to another, particularly if we take into account all the side effects and potential risks

topiramate; migraine; anticolvusant drugs; profilactic treatment

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