Standard Combination Therapy (SCT) for Treating Children with Migraine Remains Effective, Study Suggests

A new study has found that the standard combination therapy or (SCT) against pediatric migraine consisting of a combination of parenteral medications appear to yield moderate pain relief, which persists up to 1 week after administration.

Photo: Child with Migraine | InStyleHealth


The study involved 120 children aged 7-18 years where 61.1 percent are girls, who were presented to the pediatric emergency department with migraine. For the purposes of the recent study, SCT or the standard combination therapy included a bolus of intravenous (IV) saline with a combination of ketorolac, prochlorperazine, and diphenhydramine.


The result of the study was change in pain severity among children, as determined by the child through the usage of Faces Pain Scale-Revised or FPS-R tool. Measurements were gathered in person 2 hours after SCT is conducted, and through a phone follow-up after 24 hours and 7 days.


Before administering the SCT or the standard combination therapy, the median FPS-R rating was 8, which plummeted to 1 by the 2-hour mark. This representation of an 87.5 percent decline in pain severity among the subjects. Remarkably, 47 children or 39.1 percent reported that they were completely pain-free at this point.


After 24 hours monitor, the median FPS-R rating has reached 0, this is representing a significant 100 percent decline in pain among children.


However, by day 7th, migraine-related pain had slightly bounced back, such that the average FPS-R rating increased to 4. Nonetheless, the 50 percent decline relative to the baseline was still statistically significant. Furthermore, 53.3 percent and 40.8 percent of the participants were pain-free during the follow-up points.


Confining the analysis to children who had received only a single SCT does prior to discharge did not alter the preliminary findings of the study.


“Our cohort experienced a measurable degree of pain relief in response to SCT at the measured time points. We noted moderate improvement in objective measures of pain not only immediately after SCT but as late as 1week, low rates of return to the PED, marked satisfaction in both parents, and patients with respect to this form of treatment and low incidence,” the investigators said.

For complete details of the study, please click here...


Pediatr Neurol 2021;116:68-73


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