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2008 | OriginalPaper | Hoofdstuk

Effectiviteit van interventies bij kinderen met migraine

Onderzoek

Auteurs : Arianne Verhagen, Leonie Damen, Jacques Bruijn, Marjolein Berger, Jan Passchier, Bart Koes

Gepubliceerd in: Schatjes zijn het

Uitgeverij: Bohn Stafleu van Loghum

Samenvatting

Verhagen AP, Damen L, Bruijn JKJ, Berger MY, Passchier J, Koes BW. Effectiviteit van interventies bij kinderen met migraine. Huisarts Wet 2005;49(3):123-9.
Doelstelling Vaststellen van de effectiviteit en verdraagzaamheid van gangbare behandelingen van migraine bij kinderen.
Methode Een systematische review. Wij zochten in PubMed, EMBASE, PsychInfo en de Cochrane Library (Issue 2, 2004) tot juni 2004 naar gecontroleerde onderzoeken over behandeling van kinderen (tot 18 jaar) met migraine. De methodologische kwaliteit is bepaald met behulp van de Delphi-lijst. De analyses zijn uitgevoerd binnen subgroepen op basis van het type interventie. We hebben drie subgroepen gedefinieerd: acute-pijnmedicatie, preventieve medicamenteuze en niet-medicamenteuze interventies.
Resultaten In totaal hebben we 49 onderzoeken (3301 patiënten) geïncludeerd, waarvan er 16 (32,7%) van hoge kwaliteit waren. Bij 10 onderzoeken ging het om een vorm van medicatie bij acute pijn. De hoofdpijnklachten waren significant minder bij paracetamol, ibuprofen en sumatriptan neusspray vergeleken met placebo en voor prochloorperazine vergeleken met ketorolac. Alle middelen werden goed verdragen, maar sumatriptan neusspray gaf meer bijwerkingen dan placebo. Twintig onderzoeken gingen de effectiviteit na van preventieve medicatie. De hoofdpijnklachten waren significant minder na behandeling met flunarizine vergeleken met placebo. Twee RCT’s gaven strijdige resultaten over het effect van propranolol. Alle middelen werden goed verdragen en gaven verder geen significante verschillen. Negentien onderzoeken gingen de effectiviteit na van niet-medicamenteuze behandelingen. Ontspanningstherapie, ontspanningstherapie + biofeedback, ontspanningstherapie + biofeedback + cognitieve gedragstherapie bleken effectief vergeleken met wachtlijstconditie. Ontspanningtherapie in combinatie met gedragstherapie bleek effectief vergeleken met placebo. Er is tegenstrijdig bewijs voor het gebruik van speciale diëten.
Conclusies Paracetamol, ibuprofen en sumatriptan neusspray blijken effectief bij de symptomatische behandeling van migraineaanvallen bij kinderen. Enkele behandelingen zoals ontspanningstherapie en flunarizine zijn effectief als preventieve behandeling. Gezien het kleine aantal onderzoeken en de methodologische tekortkomingen in veel onderzoeken moeten de conclusies met enige voorzichtigheid worden getrokken.

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Titel: Effectiviteit van interventies bij kinderen met migraine
Auteurs: Arianne Verhagen
Leonie Damen
Jacques Bruijn
Marjolein Berger
Jan Passchier
Bart Koes
Uitgeverij: Bohn Stafleu van Loghum
Boek: Schatjes zijn het
Print ISBN: 978-90-313-5342-2

Elektronisch ISBN: 978-90-313-6642-2

Copyright: 2008
DOI: https://doi.org/10.1007/978-90-313-6642-2_19

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