Focal cerebral dysrhythmia--presenting as headache: report of a case

A 14 year old girl developed persistent headache of 6 weeks duration, which she described as a feeling of pressure, accompanied by dizziness, nausea and vomiting. Her EEG showed focal slow waves arising from the right temporo-occipital region. All other investigations were negative. Other medication was ineffective but she responded well to standard anticonvulsant therapy, and her EEG abnormality became minimal. In a case with focal slowing and pain and other handicapping symptoms, which do not respond to other remedies, a trial of antiepileptic medication is indicated even in the absence of clinical seizures and/or EEG evidence of seizure activity.