What is the role of anticonvulsants in the treatment of 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

Anticonvulsants such as valproic acid, zonisamide, and topiramate have been used as prophylactic agents with reasonable success. These agents are especially useful when a seizure disorder coexists with migraines. Good scientific evidence exists to support the use of valproic acid and topiramate but is lacking for any other anticonvulsant. In 2014, the FDA approved the use of topiramate for the prevention of headaches in migraine patients aged 12-17 years.

Although some patients on topiramate complain of cognitive changes, the authors' own experience and published data [51] are consistent with the fact that cognitive changes are not common and topiramate is safe and effective in the pediatric population.


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