[Prophylactic treatment in children with migraine presenting changes in electrophysiological and cerebral blood flow
J Biernawska1, K Miller, K Pierzchała
1II Katedra i Klinika Neurologii SAM w Zabrzu.
Insights
Prophylactic antimigrainous treatment improved clinical symptoms and brain activity in children with migraine. This study highlights the effectiveness of combined treatments for pediatric migraine, impacting both symptoms and EEG findings.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Clinical Trials
Context:
- Idiopathic headache and migraine are prevalent in children, posing diagnostic and therapeutic challenges due to a lack of specific tests.
- Electroencephalogram (EEG) abnormalities, specifically paroxysmal changes, have been observed in some pediatric migraine patients.
Purpose:
- To investigate the impact of prophylactic antimigrainous treatment on the clinical presentation and electroencephalographic (EEG) activity in children with migraine.
- To assess the efficacy of combined therapeutic approaches in managing pediatric migraine.
Summary:
- The study involved 50 children (aged 6-18) diagnosed with migraine. Routine EEG, ECG, and cerebral blood flow (CBF) were assessed. Fifteen patients with paroxysmal EEG changes received a 6-month prophylactic treatment (Hydacorn or Sermion).
- All treated children showed clinical improvement. While paroxysmal EEG changes persisted in some, the overall results demonstrated the clinical effectiveness of the prophylactic treatment and its positive influence on bioelectrical brain activity.
Impact:
- The findings suggest a potential link between migraine, epilepsy, and cerebral blood flow disturbances (angiospasm/hypoxia) in children.
- This research underscores the clinical efficacy of combined treatment strategies for pediatric migraine, positively affecting both clinical outcomes and neurophysiological markers.
Abstract:
Idiopathic headache is common in children, but lack of specific tests makes diagnosis and treatment of migraine difficult. It has been proved, that in some migrainous children paroxysmal changes in eeg records can be found. The aim of the study was to examine the influence of prophylactic treatment on clinical course and bioelectric brain activity in children. The group examined consisted of 50 migrainous children (29 girls and 21 boys aged 6-18 years, mean 11.5 y.). In every patient routine eeg and ecg were recorded, and in 30 of them cerebral blood flow was examined. Some ecg abnormalities were observed in 6 children (12%) and cerebral blood flow disturbances--in 23 (77%). In 15 patients, in whom paroxysmal changes in routine eeg were found, an average 6-month prophylactic antimigrainous treatment (with Hydacorn in 14 and with Sermion in 1 patient) was performed and then control routine eeg and 24-hours eeg were recorded. In all children clinical improvement was observed after prophylactic medication. Paroxysmal changes in eeg records persisted in 6 children. The coexistence of electroencephalographic changes with disturbed cerebral blood flow migrainous children can indicate some connection between migraine and epilepsy, and/or reflect an influence of angiospasm resulting in hypoxia on the incidence of epileptiform changes in eeg records. The obtained results show clinical efficiency of combined treatment in child migraine and they reflect its good influence on bioelectrical brain activity.
