Are there pediatric migraine specialists in Metro Detroit?

Pediatric Migraine Specialists in Metro Detroit

Yes, there are pediatric neurosurgeons and neurologists in Metro Detroit who specialize in treating pediatric migraines, and referral to these specialists is recommended for children with frequent or disabling headaches that have not responded to first-line treatments.

When to Refer to a Pediatric Migraine Specialist

The American Academy of Neurology (AAN) guidelines recommend referral to specialist care when:

• Acute medication provides insufficient pain relief in children and adolescents 1
• Children have frequent or disabling headaches requiring preventive treatment 1
• Medication overuse is present 1
• Complex migraine presentations require specialized management 2

Finding Pediatric Migraine Specialists in Metro Detroit

According to the American Board of Pediatric Neurologic Surgery guidelines, pediatric neurosurgeons are available in major metropolitan areas like Detroit and are specifically trained to manage neurological conditions in children 1. These specialists have:

• Board certification in pediatric neurologic surgery
• Specialized training in pediatric neurological conditions
• Experience with a minimum 75% pediatric neurosurgical caseload 1

Treatment Approach by Pediatric Migraine Specialists

Pediatric migraine specialists in Metro Detroit typically follow a structured approach:

1. Detailed headache assessment and diagnosis (Level B evidence) 1

   • Specific headache diagnosis using International Headache Society criteria
   • Assessment of headache frequency, severity, and disability

2. First-line acute treatments 1, 2

   • Ibuprofen for children and adolescents (Level B evidence)
   • For adolescents: consideration of triptans (sumatriptan/naproxen, zolmitriptan nasal, rizatriptan ODT)

3. Preventive treatment options when appropriate 1, 2

   • Amitriptyline combined with cognitive behavioral therapy
   • Topiramate (with appropriate birth control counseling for adolescent females)
   • Propranolol

Imaging Considerations

The American College of Radiology notes that neuroimaging has limited value in children with primary headaches 1:

• Only about 1% of children with headaches have relevant findings on MRI that explain their headaches 1
• Neuroimaging should be reserved for children with concerning neurological signs or symptoms 1

Pitfalls to Avoid

• Delayed referral: Children with frequent or disabling migraines should be referred early to specialists rather than cycling through multiple ineffective treatments 1

• Overuse of imaging: The yield of brain MRI is low in children with typical primary headache patterns 1

• Medication overuse: Specialists can help identify and manage medication overuse headaches, which are common in pediatric migraine patients 1

• Ignoring non-pharmacologic approaches: Pediatric migraine specialists emphasize lifestyle modifications and behavioral approaches alongside medication 1, 2

For families in Metro Detroit seeking pediatric migraine specialists, contacting major children's hospitals in the area or requesting a referral from a primary care physician is recommended.