Transition of headache care from childhood to adulthood: Focusing needs, barriers, and models of care. A position paper of the IHS Child and Adolescent Committee.

Headache disorders are among the most common neurological conditions in children and adolescents, often continuing into adulthood and causing substantial personal and societal burdens. Yet, the transition from childhood to adult headache care remains under-addressed, with critical clinical practice, policy, and research gaps. This narrative review synthesizes existing evidence and expert perspectives to highlight the urgent need for structured, developmentally appropriate transition models in headache care.

Pediatric-Onset Multiple Sclerosis and Primary Headache: Is There a Link?

Background: Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on pediatric populations remain limited.

Methods: The purpose of this retrospective study was to examine 64 POMS patients, divided into groups with and without headaches, to determine potential correlations between headache presence, age at POMS onset, and MRI lesion burden.

A multicentre, prospective, randomized, open-label pragmatic trial to compare the effectiveness and safety of interferon beta-1a and glatiramer-acetate in paediatric patients affected by Multiple Sclerosis.

Background: Paediatric-onset Multiple Sclerosis (POMS) is a rare, highly active disease requiring timely disease-modifying therapy.

Objectives: This trial compared the efficacy and safety of intramuscular (i.m.

Somatosensory coding of visual self-identity.

How does the brain process our bodily identity? This question has long fascinated scientists because of its potential implications for the study of self-awareness. Here, to test the idea that the somatosensory system is directly involved in coding bodily self-identity even when conveyed through vision, we probed the somatosensory system with tactile stimuli while participants observed hand images, either belonging to them (self-hand) or to another person (other-hand). In three psychophysical experiments (discovery, replicating and control samples), we found faster reaction times to tactile stimuli when paired with the self- than the other-hand image.

Development and Adaptive Function in Individuals With -Related Disorders.

Background And Objectives: Developmental impairment is common in individuals with -related disorders, although descriptions are limited. We aimed to determine trajectories and outcomes of development and adaptive function.

Methods: This was a mixed retrospective cross-sectional study of individuals from an international Natural History Study, who had neurologic/neurodevelopmental disorders due to an variant.

Clinical Variability of Pediatric MERS: Insights from a Retrospective Observational Study.

: Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare neurological disorder primarily affecting pediatric patients but also observed in adults. The radiological hallmark of MERS is a reversible lesion in the splenium of the corpus callosum. Although MERS generally has a favorable prognosis, its variable presentation poses diagnostic challenges.

Sleep Disorders in a Sample of Patients with Pediatric-Onset Multiple Sclerosis: Focus on Restless Legs Syndrome.

: Sleep disorders (SDs) and Restless Legs Syndrome (RLS) have been reported with high prevalence in Multiple Sclerosis (MS), but data on Pediatric-Onset MS (POMS) are scarce. This study aims to assess the prevalence of SDs, particularly RLS, in a POMS cohort and examine associated clinical features. : We recruited POMS patients who attended the POMS Center of the Bambino Gesù Children's Hospital between September 2021 and February 2023; they were evaluated for SDs using the Pittsburgh Sleep Quality Index (PSQI) or the Sleep Disturbance Scale for Children (SDSC) and screened for RLS.

Sleep-related painful erection: the first case in a child.

Unlabelled: Sleep-related painful erections are a rare sleep disorder characterized by recurrent nocturnal painful penile erections, typically occurring during rapid eye movement sleep, without associated pain during daytime erections. Although approximately 100 cases have been described in adult males, there are no reports of sleep-related painful erections in childhood. We present the case of a male infant born at 36 weeks' gestation, who began experiencing sleep-related painful erections and nocturnal awakenings in his first year of life.

Diagnosing migraine in children and adolescence using ID migraine: results of an Italian multicenter validation.

Background: Since migraine is the most frequent neurological condition, an early diagnosis is important to limit the impact of the disease on the quality of life. Although migraine diagnosis is based on the International Classification of Headache Disorders 3rd edition (ICHD3) criteria, other briefer questionnaires have been developed, especially for screening purpose. While the three-item ID Migraine has proved useful for migraine diagnosis in adulthood, no validated tools are available for children and adolescents.

Autism spectrum disorder and 3p24.3p23 triplication: a case report.

Background: The role of copy number variants as genomic mutations causative of neurodevelopmental disorders has been recently established. They can act as risk factors of conditions with multifactorial etiopathogenesis and incomplete penetrance, such as nonsyndromic autism, and, in this case, are often inherited from an unaffected parent. Conversely, dominant syndromes, with high penetrance, can be caused by de novo occurring variants.

RHOBTB2-related paroxysmal hemiparesis: From alternating hemiplegia to hemiplegic migraine.

We report a young patient harboring a RHOBTB2 likely pathogenic variant with recurrent episodes of headache, dysautonomia and hemiplegia consistent with hemiplegic migraine. Such episodes were responsive to flunarizine prophylaxis. Ictal MRI showed contralateral hemispheric hypoperfusion.

Ocrelizumab dose selection for treatment of pediatric relapsing-remitting multiple sclerosis: results of the OPERETTA I study.

Background: The presented study identified the appropriate ocrelizumab dosing regimen for patients with pediatric-onset multiple sclerosis (POMS).

Methods: Patients with POMS aged 10-17 years were enrolled into cohort 1 (body weight [BW] < 40 kg, ocrelizumab 300 mg) and cohort 2 (BW ≥ 40 kg, ocrelizumab 600 mg) during a 24-week dose-exploration period (DEP), followed by an optional ocrelizumab (given every 24 weeks) extension period.

Primary Endpoints: pharmacokinetics, pharmacodynamics (CD19 B-cell count); secondary endpoint: safety; exploratory endpoints: MRI activity, protocol-defined relapses, Expanded Disability Status Scale (EDSS) score change.

Pediatric-onset Multiple Sclerosis treatment: a multicentre observational study comparing natalizumab with fingolimod.

Background: Pediatric-onset Multiple Sclerosis (POMS) patients show more inflammatory disease compared with adult-onset MS. However, highly effective treatments are limited with only fingolimod being approved in Italy and natalizumab prescribed as off-label treatment.

Objectives: to compare the efficacy of natalizumab versus fingolimod in POMS.

Isolated Intracranial Hypertensions as Onset of Myelin Oligodendrocyte Glycoprotein Antibody Disease.

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is characterized by multiple phenotypic conditions such as acute disseminated encephalomyelitis, optic neuritis, and myelitis. MOGAD's spectrum is expanding, with potential symptoms of increased intracranial pressure that are similar to idiopathic intracranial hypertension (IIH). We report a boy with new-onset continuous headache and a brain MRI at onset suggesting idiopathic intracranial hypertension (IIH).

Headache in Sturge-Weber syndrome: A systematic review.

Background: Sturge-Weber syndrome (SWS) is a neurocutaneous disorder for which the neurological aspects, particularly headaches, remain poorly understood, despite significantly affecting morbidity. The present study aimed to elucidate the prevalence, characteristics and treatment strategies, as well as explore the pathogenesis of headaches, in SWS.

Methods: Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed observational studies, case reports and series from eight databases (Cochrane Library, EBSCO, Embase, Medline, PubMed, Science Direct, Scopus and Web of Science), published from 1978 to 2023, to investigate the prevalence, characteristics, medication response and pathogenic theories of headaches in SWS.

Lower Urinary Tract Dysfunction in Pediatric Patients with Multiple Sclerosis: Diagnostic and Management Concerns.

Background: Multiple sclerosis (MS) is increasing in the pediatric population and, as in adults, symptoms vary among patients. In children the first manifestations can sometimes overlap with acute neurological symptoms. Urological symptoms have not been much studied in childhood.

Unsatisfactory response to acute medications does not affect the medication overuse headache development in pediatric chronic migraine.

Background: Chronic migraine (CM) negatively impacts the quality of life of 2 to 4% of pediatric patients. In adults, CM is frequently linked to medication overuse headache (MOH), but there is a much lower prevalence of MOH in children. A suboptimal response to acute therapies may lead to their reduced use, thus preventing MOH development in children and adolescents.

Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache.

Despite its rarity, cluster headache can affect children. Patients with cluster headaches often experience symptoms in their adolescence, but the time it takes for a correct diagnosis can be very long. Cluster headache can be mistaken for other pathologies, which can result in patients being diagnosed and treated incorrectly.

The Role of the Combination Paracetamol/Caffeine in Treatment of Acute Migraine Pain: A Narrative Review.

Introduction: Thirty years ago, the first migraine-specific drugs (triptans) appeared. Today two new categories (gepants and ditans) are marketed for acute migraine treatment. That said, is there still a role for conventional therapy? The aim of the present narrative review is to provide an expert overview examining the possible role of the combination paracetamol/caffeine in treatment of acute migraine pain.