The objective was to determine the initial utility of magnesium salt as a treatment for paediatric, episodic, and chronic tension-type headache (TTH). The study took the form of a clinical replication series in the Outpatient Headache Center at the National Neurological Institute “C. Besta", Milan, Italy. The patients were five children/adolescents with episodic and four with chronic TTH reporting consecutively for treatment. Magnesium pidolate (2.25 g) was given twice per day for two months, with one year of follow-up. No other treatment was provided. Patients with episodic TTH revealed 76.0% symptom reduction, with 80% of the sample achieving reductions greater than 50%. The patients with chronic TTH revealed 87.5% symptom reduction, with 100% of the sample achieving reductions greater than 50%. Analgesic consumption decreased significantly for chronic TTH. Only one child took medication in the episodic TTH group. No significant changes occurred with respect to depression and anxiety, but these measures were not clinically elevated at the start of treatment. Although uncontrolled, the initial findings are encouraging and suggest that further, better controlled research is warranted.

Comments: Hopeful start for kids with CTTH. Now we need a randomized controlled study.—Stewart J. Tepper, MD

It's not obvious from the abstract but presumably this is oral magnesium pidolate. It would be helpful to know more about the pharmacology of this somewhat unusual magnesium salt, eg, does it cause diarrhea magnesium sulphate as does its cousin?—David S. Millson, MD