Question 2: Does intranasal sumatriptan use relieve migraine in children and young people?

You are a paediatric registrar in clinic, and you see a 13-year-old boy with a recent diagnosis of migraine. His general practitioner has discussed options such as pizotifen, propranolol and topiramate, but his parents do not like the idea of him taking a medication daily. Ibuprofen has been tried at the onset of headaches, but has not worked. His parents wonder if there is any other medication that could be used when needed to relieve the pain. You have heard of intranasal triptans being used in adults and sometimes in older children. You decide to review the evidence. In children over the age of 12 years with migraine (patient), does treatment with intranasal sumatriptan (intervention) reduce the pain (outcome) associated with migraine headache? MEDLINE (1950–present) and Embase (1980–present) were searched via the OVID interface using the keywords ‘sumatriptan’ and ‘Migraine’. Limits included ‘human’ and English language articles only. Forty-seven articles were found, and four were found to be suitable. Migraine is commonly seen in children and adolescents, and can have a significant effect on a child's …