What is included in abortive therapy for pediatric headache?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Answer

Abortive therapy for migraine and tension-type headaches may include the following:

  • Triptans (sumatriptan, almotriptan, rizatriptan, and others) (see the image below)

  • Trigeminovascular system. The trigeminal nerve fib Trigeminovascular system. The trigeminal nerve fibers around basal cerebral and meningeal vessels are triggered (various stimuli are possible), and a vicious cycle starts in which the nerve terminals release calcitonin gene-related peptide (CGRP), substance P, vasoinhibitory peptide (VIP), and other mediators of local neurogenic inflammation and vasodilatation. The latter further stimulates the nerve endings. On the other end of the nerve, painful messages are transmitted toward central centers, including thalamus and cortex, and the sensation of pain arises. Modern drugs, such as the triptans, act at 3 levels, via 5-HT 1 B and D receptors; they vasoconstrict the vessels, reduce the release of the above-mentioned mediators, and decrease the central transmission of pain impulses.
  • Isometheptene and ergotamines

  • Analgesics


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