# Onabotulinumtoxin-A for Chronic Migraine in Children and Adolescents: A Narrative Review of Current Evidence and Clinical Perspectives

## TL;DR

This review discusses the use of onabotulinumtoxinA for treating chronic migraines in children and adolescents, summarizing its effectiveness and safety.

## Contribution

The paper provides a narrative review of current evidence and clinical perspectives on onabotulinumtoxinA for pediatric chronic migraine.

## Key findings

- OnabotulinumtoxinA shows potential efficacy in reducing migraine frequency in pediatric patients.
- Safety and tolerability profiles are generally favorable, though more research is needed.
- Current evidence is limited, and further studies are required to guide clinical practice.

## Abstract

Chronic migraine (CM) in childhood and adolescence is associated with a high disease burden, including impaired quality of life, school absenteeism, and reduced daily functioning. OnabotulinumtoxinA (ONA) is approved for prophylactic treatment of CM in adults, but its use in pediatric patients remains off-label, with evidence still limited. This narrative review summarizes current data on the efficacy, safety, and tolerability of ONA in pediatric CM, drawing from randomized controlled trials, prospective cohorts, and retrospective series. In addition to summarizing efficacy and safety data, our review aims to focus on potential practical clinical implications and on discussion points and research questions that remain open.