Summary: Migraine headaches are pretty common in children and adolescents, too. However, there are few treatment options in this age group, as FDA has approved very few drugs for treating migraine in children. It means that doctors often have to use some medications off-label. Studies suggest that untreated migraine in children may affect not only schooling but also brain development. Fortunately, an Israeli company has now developed a remote neurostimulation device that is even better than most commonly used medicines for migraine pain treatment in young adults.
Migraine headaches are pretty common in children and young adults. Studies show that migraine and cluster headaches even affect preschool children. In school-aged children, almost 10% may have migraine headaches, and these numbers may be pretty high for adolescent females.
Migraine headaches pose specific challenges in this age group, as they can disrupt education and affect development. Moreover, doctors find it quite challenging to manage such headaches due to a limited number of treatment options. Most drugs used to treat migraine in adults are not approved for use in children and young adults.
Therefore, doctors are left with few options, like prescribing over-the-counter medications that often fail to provide sufficient relief. Or doctors can prescribe migraine drugs like CGRP inhibitors off-label, which is not an ethical way to treat these headaches.
There is a reason why doctors often need to use unapproved drugs to treat migraine in children and young adults. Studies show that frequent migraine attacks may affect neurodevelopment. It may reduce the formation of ‘gray matter’ in different brain parts2.
Hence, doctors are faced with a dilemma. If they do not treat migraine, this would have a long-term negative impact on brain development. However, treating migraine with drugs not approved for use in young adults carries certain risks.
Thus, doctors think that there is an urgent need to find safer treatment options for managing migraine headaches in children and young adults, and it appears that there is one such way.
Of course, using devices to treat headaches have some distinct benefits, like lower risk of unforeseeable side effects. An Israeli medical tech company has developed a device called Nerivio as a new migraine treatment in both young and older adults.
It is a remote neuromodulation device. The device is worn on the upper arm and is controlled through a smartphone app. It generates electric impulses to stimulate nerves and thus disrupt migraine pain signals.Early studies have already shown that the device works, and it is pretty simple to use.
In a new study published in the journal Pain Medicine, researchers demonstrated that Nerivio is safe and effective for treating migraine headaches in adolescents. The latest study was done on 35 adolescents aged 12 to 17 living with migraines. It was a comparative study done for two months. Researchers compared the ability of the device to help with migraine headaches with over-the-counter drugs and oral triptans.
The findings of the study were quite encouraging. After two hours, 37% of patients reported complete pain relief compared to just 8.6% with medications. In addition, more than 80% of the patients reported some pain relief from the device compared to 57% with drug therapy.
Since the device was safe and did not cause any side effects, and was considerably better than medications, experts concluded that it could be used as a first-line treatment in young adults or adolescents. Moreover, the device is relatively inexpensive and a long-term investment. Finally, since it is an FDA-approved device, it is also covered by insurance.
Theranica, the company that produces these devices, is planning to check if their device can also help prevent migraine headaches. Not only that, the company plans to test the device for other chronic pain conditions in addition to migraine.
By Gurpreet Singh Padda, MD, MBA