Journal of Pediatric Neurology 2023; 21(06): 417-420
DOI: 10.1055/s-0042-1750796
Original Article

Hydroxocobalamin Treatment and Pediatric Migraine Disability Assessment Scale Scores

1   Department of Pediatric Neurology, Haseki Training and Research Hospital, Istanbul, Turkey
Ceren Dogan
2   Department of Pediatrics, Haseki Training and Research Hospital, Istanbul, Turkey
› Institutsangaben


Migraine is a common neurologic disorder in children, especially in adolescents. It can affect the school performance, family, and social daily activities. The Pediatric Migraine Disability Assessment Scale (PedMIDAS) is commonly used in young patients. This study evaluated vitamin B12 deficiency in children with migraine and the effect of hydroxocobalamin treatment on PedMIDAS scores. The study group comprised patients with vitamin B12 deficiency and diagnosed migraine. The PedMIDAS questionnaire was conducted before and 3 months after hydroxocobalamin treatment. PedMIDAS scores were evaluated and compared before and after hydroxocobalamin treatment. The mean ± standard deviation of vitamin B12 level was 175.9 ± 21.3 pg/mL in children with migraine. The PedMIDAS scores were significantly lower after hydroxocobalamin treatment than before treatment (p < 0.001). These results indicated that hydroxocobalamin made a positive contribution to the mitigation of migraine symptoms in children and that treating vitamin B12 deficiency could be a useful option.

Authors' Contributions

Surgical and medical practices: S.A. and C.D.; concept: S.A.; design: S.A.; data collection and/or processing: S.A. and C.D.; analysis or interpretation: S.A. and C.D.; literature search: S.A. and C.D.; and writing manuscript: S.A. and C.D.


Eingereicht: 20. Februar 2022

Angenommen: 18. Mai 2022

Artikel online veröffentlicht:
11. Juli 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Neeb L, Reuter U. Nitric oxide in migraine. CNS Neurol Disord Drug Targets 2007; 6 (04) 258-264
  • 2 Togha M, Razeghi Jahromi S, Ghorbani Z, Martami F, Seifishahpar M. Serum vitamin B12 and methylmalonic acid status in migraineurs: a case-control study. Headache 2019; 59 (09) 1492-1503
  • 3 Pizza V, Agresta A, Cassano D, d'Amato CC, Capasso A. The role of homocysteine in the pathogenesis of migrane. Curr Neurobiol 2013; 4 (02) 19-24
  • 4 Mahmoud AN, Mentias A, Elgendy AY. et al. Migraine and the risk of cardiovascular and cerebrovascular events: a meta-analysis of 16 cohort studies including 1 152 407 subjects. BMJ Open 2018; 8 (03) e020498
  • 5 Bianchi A, Salomone S, Caraci F, Pizza V, Bernardini R, D'Amato CC. Role of magnesium, coenzyme Q10, riboflavin, and vitamin B12 in migraine prophylaxis. Vitam Horm 2004; 69: 297-312
  • 6 Stewart WF, Lipton RB, Whyte J. et al. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology 1999; 53 (05) 988-994
  • 7 Hershey AD, Powers SW, Vockell A-L, LeCates S, Kabbouche MA, Maynard MK. PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology 2001; 57 (11) 2034-2039
  • 8 Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology 2001; 56 (06, Suppl 1): S20-S28
  • 9 Stewart WF, Lipton RB, Kolodner K. Migraine disability assessment (MIDAS) score: relation to headache frequency, pain intensity, and headache symptoms. Headache 2003; 43 (03) 258-265
  • 10 Akyol A, Kiylioglu N, Aydin I. et al. Epidemiology and clinical characteristics of migraine among school children in the Menderes region. Cephalalgia 2007; 27 (07) 781-787
  • 11 Rasmussen SA, Fernhoff PM, Scanlon KS. Vitamin B12 deficiency in children and adolescents. J Pediatr 2001; 138 (01) 10-17
  • 12 Devalia V, Hamilton MS, Molloy AM. British Committee for Standards in Haematology. Guidelines for the diagnosis and treatment of cobalamin and folate disorders. Br J Haematol 2014; 166 (04) 496-513
  • 13 Shaik MM, Gan SH. Vitamin supplementation as possible prophylactic treatment against migraine with aura and menstrual migraine. BioMed Res Int 2015; 2015: 469529
  • 14 Shaik MM, Tan HL, Kamal MA, Gan SH. Do folate, vitamins B6 and B12 play a role in the pathogenesis of migraine? The role of pharmacoepigenomics. CNS Neurol Disord Drug Targets 2014; 13 (05) 828-835
  • 15 Calik M, Aktas MS, Cecen E. et al. The association between serum vitamin B12 deficiency and tension-type headache in Turkish children. Neurol Sci 2018; 39 (06) 1009-1014
  • 16 van der Kuy PHM, Merkus FWHM, Lohman JJHM, ter Berg JW, Hooymans PM. Hydroxocobalamin, a nitric oxide scavenger, in the prophylaxis of migraine: an open, pilot study. Cephalalgia 2002; 22 (07) 513-519
  • 17 Tozzi E, Onofri A, Iapadre G. et al. C677T methylenetetrahydrofolate reductase homozygosis and vitamin supplement in migraineur children. Int Neuropsychiatr Dis J 2018; 12 (03) 1
  • 18 González-Gross M, Benser J, Breidenassel C. et al; HELENA Study Group. Gender and age influence blood folate, vitamin B12, vitamin B6, and homocysteine levels in European adolescents: the Helena Study. Nutr Res 2012; 32 (11) 817-826
  • 19 Varkal MA. Genel pediatri polikliniği vakalarında B12 vitamini eksikliği. Child 2022; 22 (01) 15-20
  • 20 Aydin H, Bucak IH, Geyik M. Vitamin B12 and folic acid levels in pediatric migraine patients. Acta Neurol Belg 2021; 121 (06) 1741-1744