Overview of diagnosis and management of paediatric XXXX . Part II: therapeutic management.

@entity1 @entity2704 @entity10 @entity158
A thorough evaluation of @entity10 in @entity1 and adolescents is necessary to make the correct diagnosis and initiate treatment. In part 1 of this article (  zge et al. in J @entity158 , 2010), we reviewed the diagnosis of @entity10 in @entity1 and adolescents. In the present part, we will discuss therapeutic management of primary @entity10 . An appropriate management requires an individually tailored strategy giving due consideration to both non-pharmacological and pharmacological measures. Non-pharmacological treatments include relaxation training, biofeedback training, cognitive-behavioural therapy, different psychotherapeutic approaches or combinations of these treatments. The data supporting the effectiveness of these therapies are less clear-cut in @entity1 than in adults, but that is also true for the data supporting medical treatment. Management of @entity2704 and TTH should include strategies relating to daily living activities, family relationships, school, friends and leisure time activities. In the pharmacological treatment age and gender of @entity1 , @entity10 diagnosis, comorbidities and side effects of medication must be considered. The goal of symptomatic treatment should be a quick response with return to normal activity and without relapse. The drug should be taken as early as possible and in the appropriate dosage. Supplementary measures such as rest in a quiet, darkened room is recommended. Pharmaco-prophylaxis is only indicated if lifestyle modification and non-pharmacological prophylaxis alone are not effective. Although many prophylactic medications have been tried in paediatric @entity2704 , there are only a few medications that have been studied in controlled trials. Multidisciplinary treatment is an effective strategy for @entity1 and adolescents with improvement of multiple outcome variants including frequency and severity of @entity10 and school days missed because of @entity10 . As a growing problem both @entity1 and families should be informed about medication overuse and the @entity1 's drug-taking should be checked.
