Khan Adnan, Liu Sufang, Tao Feng
Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX 75246, USA.
Brain Sci. 2025 Mar 6;15(3):280. doi: 10.3390/brainsci15030280.
Pediatric migraine is a prevalent neurological disorder that significantly impacts children's quality of life, academic performance, and social interactions. Unlike migraines in adults, pediatric migraines often present differently and involve unique underlying mechanisms, making diagnosis and treatment more complex. This review discusses the clinical phases of pediatric migraine, key trigger factors, sex- and age-related differences, and the role of childhood maltreatment in migraine development. We also discuss episodic syndromes such as cyclic vomiting syndrome, abdominal migraine, benign paroxysmal vertigo, and benign paroxysmal torticollis, along with comorbidities such as psychiatric disorders, sleep disturbances, and epilepsy. The underlying pathophysiological mechanisms for pediatric migraines, including genetic predispositions, neuroinflammation, and gut microbiota dysbiosis, are summarized. Current therapeutic strategies, including conventional and emerging pharmacological treatments, nutraceuticals, and non-pharmacological approaches, are evaluated. Non-pharmacological strategies, particularly evidence-based lifestyle interventions such as stress management, diet, hydration, sleep, exercise, screen time moderation, and cognitive behavioral therapy, are highlighted as key components of migraine prevention and management. The long-term prognosis and follow-up of pediatric migraine patients are reviewed, emphasizing the importance of early diagnosis, and tailored multidisciplinary care to prevent chronic progression. Future research should focus on novel therapeutic targets and integrating gut-brain axis modulation, with a need for longitudinal studies to better understand the long-term course of pediatric migraine.
儿童偏头痛是一种常见的神经系统疾病，严重影响儿童的生活质量、学业成绩和社交互动。与成人偏头痛不同，儿童偏头痛的表现往往不同，涉及独特的潜在机制，这使得诊断和治疗更加复杂。本综述讨论了儿童偏头痛的临床阶段、关键触发因素、性别和年龄相关差异，以及童年虐待在偏头痛发病中的作用。我们还讨论了发作性综合征，如周期性呕吐综合征、腹型偏头痛、良性阵发性眩晕和良性阵发性斜颈，以及共病，如精神障碍、睡眠障碍和癫痫。总结了儿童偏头痛的潜在病理生理机制，包括遗传易感性、神经炎症和肠道微生物群失调。评估了当前的治疗策略，包括传统和新兴的药物治疗、营养补充剂和非药物方法。非药物策略，特别是基于证据的生活方式干预措施，如压力管理、饮食、水合作用、睡眠、运动、适度控制屏幕时间和认知行为疗法，被强调为偏头痛预防和管理的关键组成部分。回顾了儿童偏头痛患者的长期预后和随访情况，强调早期诊断以及量身定制的多学科护理对于预防慢性进展的重要性。未来的研究应聚焦于新的治疗靶点以及整合肠-脑轴调节，有必要开展纵向研究以更好地了解儿童偏头痛的长期病程。
