[Hemicrania in children: diagnostic and therapeutic problems (author's transl)]

Four children with migraine raised some problems of differential diagnosis (cerebral circulatory disorders; structural brain diseases; or primary psychiatric disorders). Organic lesions were excluded through special investigations (EEG, CAT, Scintigraphy, Angiography etc.). Relationships between migraine and epilepsy in children were considered and the recent literature was reviewed. No agreement was reached on how to evaluate paroxysmal electroencephalograms recorded during migrainous episodes. In a child with personal and family history of migraine suffering from a sudden attack of acute headache accompanied by focal neurological deficits, migraine is the most likely diagnosis. Only if the neurological deficit fails to resolve rapidly (after a few hours), a detailed investigation is necessary (CAT etc.). A paroxysmal electroencephalogram during the attack of migraine does not imply necessarily a diagnosis of epilepsy. Children with history of migraine must be treated with specific anti-migranious drugs even if paroxysmal EEGs are recorded during the migraine attack. It must be remembered that both disorders (i.e. migraine and epilepsy) can exist in the same patient.