مقایسه اثرات درمان سدیم والپروات و پروپرانولول در پیشگیری از سردردهای میگرنی کودکان

Background: Although many agents have been used for migraine prophylaxis, little evidence is available to support their efficacy in children. Sodium valporate is one of the drugs that has been proved effective in adults. To compare the effectiveness and safety of sodium valportate and propranolol in childhood migraine, this study was designed. Methods: A 15 months open labeled crossover clinical trial was carried out having a 4 week medication free baseline phase and a 8 week treatment phase for each drug and a 4 week wash out period before crossing over. Fifty two patients started the study and we missed 4 of them due to poor compliance. Forty eight patients (23 girl and 25 boys) were randomized to sodium valporate or propranolol(1:1 ratio) treatment group. Results: The response to treatment was evaluated on basis of frequency and severity of migraine attacks. Sixty percent of valporate treated patients and 78 precent of propranolol treated ones showed 50% or greater reduction in headache frequencies from the baseline phase. Thirthy one percent of valporate and 45 precent of propranolol treated group revealed at least one grade improvement in functional restriction. McNemar statistical analysis didn;apost show remarkable difference between groups concerning both frequency (κ2=2.4) and severity (κ2=3.36). No serious side effect was seen during treatment. Conclusion: Sodium valporate was generally well tolerated in this study and showed favorable efficacy in childhood migraine.