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Headache in children with centrotemporal spikes
D Melchionda1, A Verrotti, F Chiarelli
1Department of Neurology, University of Chieti, Italy.
Insights
Centrotemporal spikes (CTS) in children with headaches are not exclusive to epilepsy. Headache frequency correlates with CTS, suggesting a link between these neurological events.
Area of Science:
- Neurology
- Pediatrics
- Clinical Neurophysiology
Background:
- Headache is a common symptom in childhood.
- Rolandic centrotemporal spikes (CTS) are typically associated with benign childhood epilepsy.
Purpose of the Study:
- To investigate the long-term evolution of headache in children with electroencephalogram (EEG) confirmed CTS.
- To determine the relationship between CTS and headache frequency over time.
Main Methods:
- A cohort of 32 children with headache and CTS was compared to 52 age- and sex-matched controls with headache but no EEG abnormalities.
- Patients were followed for 5 years, monitoring headache frequency and EEG patterns.
- Statistical analysis assessed the correlation between CTS and headache attacks.
Main Results:
- Headache frequency decreased in most children, similar to controls.
- A significant positive correlation was found between CTS and headache frequency at baseline (r = 0.58) and follow-up (r = 0.64).
- Increased headache frequency in 12.5% of patients was associated with higher CTS frequency; two patients showed EEG pattern changes.
Conclusions:
- CTS are not pathognomonic for centrotemporal epilepsy in children presenting with headaches.
- The evolution of CTS and headache frequency in children are statistically related, indicating a potential neurophysiological link beyond epilepsy.
Abstract:
The aim of the study was to evaluate the long-term evolution of headache associated with rolandic centrotemporal spikes (CTS). The patient group consisted of a group of 32 children who suffered from headache and presented CTS at electroencephalogram (EEG). As the control group, we selected 52 sex- and age-matched children with headache without any EEG abnormalities. During a follow-up of 5 years none of them showed epileptic seizures. The number of headache attacks decreased in the majority of patients, as in the controls. A good correlation could be identified between CTS and the number of headaches attacks both at baseline (r = 0.58, P < 0.001) and at follow-up (r = 0.64, P < 0.001). In four children (12.5%), the frequency of headache attacks increased and this increase was associated with a higher frequency of CTS. In two patients, a change in the EEG pattern was observed during follow-up, with a 'migration' of the epileptiform complex from central to parietooccipital leads. In conclusion, these findings confirm that CTS are not pathognomonic of centrotemporal epilepsy and that evolution of CTS and headache in children are statistically related.