Aim To assess the available evidence for the efficacy and safety of Topiramate in the prophylaxis of paediatric migraine.

Methods A literature search of original articles, conference abstracts, and references from 1974 to September 2009 were performed, using six databases limited to English language. Standardised criteria for study definition, data extraction and critical appraisal were used.

Results Of 19 studies reviewed, 5 randomised controlled studies were included and the results are given in the table 1. All the studies suggested that Topiramate was generally well tolerated and lack of data looking at its use in children younger than 6 years of age.

Conclusions Topiramate appears to be effective in treatment of chronic paediatric migraine, especially in reducing frequency of headaches (Grade B). Treatment with Topiramate may be associated with improvement in quality of life (Grade B) and further randomised controlled trials would help in consolidating the evidence.