Recurrent headaches in 100 children. Electroencephalographic abnormalities and response to phenytoin (Dilantin)

Area of Science:

• Neurology
• Pediatrics
• Clinical Medicine

Background:

• Chronic, recurrent headaches are common in children.
• Previous studies suggest potential links between headaches, electroencephalographic (EEG) findings, and epilepsy.

Purpose of the Study:

• To investigate the causes of chronic headaches in children.
• To evaluate electroencephalographic (EEG) findings and the efficacy of phenytoin in treating pediatric headaches.
• To determine if EEG abnormalities and phenytoin response are sufficient for epilepsy diagnosis.

Main Methods:

• A study of 100 children with chronic, recurrent headaches.
• Assessment of medical history, including head injury and convulsions.
• Electroencephalographic (EEG) evaluations.
• Diagnosis of headache types (migraine, tension, psychogenic).
• Evaluation of response to phenytoin (Dilantin) and other medications.

Main Results:

• 41% of children reported a history of head injury; 15% had convulsions.
• Abnormal EEG findings were noted in 45% of children (18% severe, 27% moderate).
• Migraine diagnosed in 42%, tension headaches in 18%, and psychogenic factors in 21%.
• Phenytoin controlled migraine in 77% and seizure equivalent headaches in 40%.
• Phenytoin response was independent of EEG abnormality severity.

Conclusions:

• Phenytoin is effective for managing migraines and seizure equivalent headaches in children.
• Abnormal EEG findings and positive response to phenytoin alone are insufficient to diagnose epilepsy in children with recurrent headaches.
• Further investigation is needed to differentiate headache causes and guide epilepsy diagnosis.