Background

Migraine is the primary cause of headache in childhood. Most of the patients can be treated with lifestyle changes and acute attack treatment. Prophylaxis should be considered when necessary, such as frequent absenses from school, poor quality of life, recurring emergency room visits and frequent

analgesic use. We aimed to compare the efficacy and side effects of the drugs being used in migraine prophylaxis which were chosen according to the characteristics of the patients.

Methods

186 patients were evaluated who aged 6-18 years and were diagnosed with migraine according to

The International Classification of Headache Disorders, 3rd edition beta version (ICH-3β). Propranolol, topiramate, flunarizine and cyproheptadine were given as prophylactic treatment. PedMIDAS (Pediatric Migraine Disability Assessment Score) scores, severity, duration and frequency of the headache attacks were evaluated from the medical records and the pre- and post-treatment values were compared.

Results

The median age of the patients was 14 (min;max: 6;18) years and the mean duration of headache was 29.6±21.02 months. Mean PedMIDAS score was 29.9±21.2 before and 14.9±12.5 after treatment. Most reduction in the frequency of attacks was observed in the topiramate group. All four drugs significantly reduced PedMIDAS scores. The most common side effect was palpitations.

Conclusions

Significant improvement was found in PedMIDAS in all drug groups. Topiramate was found to be the most effective drug in reducing the frequency of attacks. All four drugs in this study may be preffered for migraine prophylaxis in terms of effectiveness and safety.