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Efficacy and Tolerability of Intravenous Valproic
Acid in Acute Adolescent Migraine
Pamela Reiter, Jason Nickisch, Glenn Merritt
Posted: December 2005  
Headache 2005;45:899-903

Objective:   To describe the efficacy and tolerability of rapid intravenous valproic acid (VPA) infusions in children with severe migraine headache.

Background:   Intravenous VPA is an emerging treatment option for acute migraine headache. Adult data suggests both efficacy and tolerability of rapid VPA infusions a abortive therapy, but little data exist in children.

Methods:   We conducted a retrospective chart review of all children who received intravenous VPA at The Childrenís Hospital Headache Clinic during an 18-month study period. Baseline intensity of headache pain, time at which maximum relief was attained, pain reduction following therapy, dose and duration of VPA infusion(s), patientís pulse, blood pressure, respiratory rate, and pulse oximetry were collected. Adverse events were also recorded.

Results:   Thirty-one children requiring 58 clinic visits and 71 VPS infusions were included. Most visits resulted in only one dose of VPA for desired pain relief. Some children required a second dose. VPS infusions were well tolerated. Adverse events described included cold sensation, dizziness, nausea, possible absence seizure, paraesthesia, and tachycardia.

Conclusions:   Rapid infusion of intravenous VPA is generally well tolerated and may play a role in the management of children with acute migraine headache. Prospective, controlled trials to further investigate this treatment in children are warranted.