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Pediatric Headache and Seizures
Christopher B Oakley1, Eric H Kossoff1
1Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Insights
Pediatric headache and seizures are common neurological issues that can overlap, making diagnosis challenging. This review covers their epidemiology, diagnosis, and treatment in children.
Area of Science:
- Pediatric Neurology
- Neuroscience
Background:
- Headache and seizures are frequent pediatric neurological complaints.
- These conditions can coexist and present with overlapping symptoms, complicating diagnosis.
- Underlying neurological disorders can increase the risk for both headaches and seizures.
Purpose of the Study:
- To review the epidemiology of pediatric headaches and seizures.
- To explore diagnostic overlaps and differentiation strategies for these conditions.
- To discuss treatment options and prognosis for coexisting headaches and seizures in children.
Main Methods:
- Literature review focusing on pediatric neurology.
- Analysis of diagnostic challenges in differentiating atypical seizures from migraine variants.
- Examination of treatment approaches for acute and prophylactic management.
Main Results:
- Differentiating between seizures and headaches requires a thorough history and appropriate investigations.
- Acute treatment is often diagnosis-specific, while prophylactic treatments may address both conditions.
- Understanding the overlap is crucial for effective management.
Conclusions:
- Accurate diagnosis of pediatric headache and seizures is essential for effective treatment.
- A focused history and investigative tools aid in differentiating these conditions.
- Prophylactic treatments offer potential for managing both headaches and seizures concurrently.
Abstract:
Headache and seizures are two of the most common complaints seen in the field of pediatric neurology with headache being number one. Both these conditions may coexist. Where the difficulty begins is when the symptoms are not clear cut in making a diagnosis, and conditions are possible as either an atypical seizure or migraine variant. What further complicates matters is the fact that there are many underlying neurologic conditions that carry with them a higher likelihood of developing both headaches and seizures, making each a distinct possibility when obtaining a history from a parent about unusual spells. Although differentiating between seizure and headache may not be easy, with a focused yet thorough history and appropriate use of investigative tools, it can be done. Coming to the correct diagnosis is only the start; once seizures and or headaches have been appropriately diagnosed then the real challenge begins and that is finding a way to successfully treat the headaches and seizures. Within pediatric neurology, the acute options tend to be more diagnosis specific whereas the prophylactic ones may overlap and treat both headaches and seizures. In the following review, we will discuss the epidemiology of pediatric headaches and seizures, the overlap between these 2 conditions in diagnosis, as well as how to tell them apart, and the treatment options and prognosis of both common neurologic disorders in children.
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