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New Insights into Migraine Prevention for Children and Teens

In a groundbreaking preliminary study, researchers have found that the medication zonisamide, which has traditionally been used to treat seizures, may also serve as a promising preventive treatment for migraines in children and adolescents. This study is set to be presented at the upcoming 77th Annual Meeting of the American Academy of Neurology (AAN), scheduled for April 5–9, 2025. The findings spotlight the struggles many young people face living with migraine, a condition that often results in missed school days and limited participation in other activities.

Dr. Anisa Kelley from Northwestern University Feinberg School of Medicine leads the research, which emphasizes the current lack of options for effective migraine prevention in this demographic. Presently, only one medication has received FDA approval for migraine prevention among children and teens. Therefore, the potential introduction of zonisamide as an alternative is especially significant given the debilitating nature of migraine episodes.

The study analyzed health records of 256 children and teenagers diagnosed with migraines who had been prescribed zonisamide for preventive purposes. A striking 28% of these individuals had refractory migraines, meaning they struggled with migraines that did not respond to at least two other treatments. Researchers meticulously tracked the number of headache days each participant experienced before and after starting zonisamide.

For comprehensive analysis, the participants were divided into three subgroups according to how long they had been on the medication before their follow-up consultation: one group followed up within the first month, the second group within two to six months, and the third group after six months of treatment. The results were encouraging. All participants experienced a substantial decrease in headache days each month, dropping from a median of 18 days to just six days by the first follow-up visit.

Notably, the subgroup that followed up within the two-to-six-month window exhibited the most significant reduction, with a median decrease of six headache days. This suggests that zonisamide may require a minimum duration of treatment to achieve its full effects, highlighting its potential as a long-term management solution rather than a quick fix.

Dr. Kelley expressed optimism regarding these findings but tempered expectations by acknowledging the limitations of the study. One major limitation was the absence of a control group for comparison, which means that while there appears to be a correlation between zonisamide use and fewer headaches, causation cannot be conclusively established. Future studies, including randomized control trials, are necessary to better understand its effectiveness and to explore its viability as the go-to treatment option for difficult-to-treat migraines in young patients.

This study was supported by the Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago, reflecting the collaborative effort to improve neurological health for the younger population.

In conclusion, the ongoing exploration into the treatment of migraines in children and teens through medications like zonisamide is promising. With further research and clinical trials, we may soon have better tools at our disposal to combat this debilitating condition that affects countless children and teenagers across the globe. For more information regarding migraines and their treatment options, families are encouraged to visit BrainandLife.org, a resource from the American Academy of Neurology that connects patients and caregivers to expert information.