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Friday, January 1, 2010

Another article discussing the increase in migraines in children and adolesents due to the trigeminovascular system.

The key phrase " conjunction with the peripheral trigeminovascular system," refers to the nerves and muscles and receptors of the jaw and face. This is exactly the type of problem that is often if not almost always best treated with a neuromuscular orthotic. In children and young adolescents it is ideal to evaluate and correct the underlying problems before central sensitization occurs. There is extensive dental literature on the effect of jaw development on breathing and swallowing.

J Headache Pain. 2009 Aug;10(4):227-33. Epub 2009 Jun 9.
Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification.
Charles JA, Peterlin BL, Rapoport AM, Linder SL, Kabbouche MA, Sheftell FD.

New Jersey Medical School, Bayonne, NJ, USA. jamesacharlesmd@aol.com
There is evidence that the prevalence of migraine in children and adolescents may be increasing. Current theories of migraine pathophysiology in adults suggest activation of central cortical and brainstem pathways in conjunction with the peripheral trigeminovascular system, which ultimately results in release of neuropeptides, facilitation of central pain pathways, neurogenic inflammation surrounding peripheral vessels, and vasodilatation. Although several risk factors for frequent episodic, chronic, and refractory migraine have been identified, the causes of migraine progression are not known. Migraine pathophysiology has not been fully evaluated in children. In this review, we will first discuss the evidence that early therapeutic interventions in the child or adolescent new onset migraineur, may halt or limit progression and disability. We will then review the evidence suggesting that many adults with chronic or refractory migraine developed their migraine as children or adolescents and may not have been treated adequately with migraine-specific therapy. Finally, we will show that early, appropriate and optimal treatment of migraine during childhood and adolescence may result in disease modification and prevent progression of this disease.

PMID: 19506799 [PubMed - indexed for MEDLINE]

posted by Dr Shapira at 2:55 AM

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