Related Experiment Videos
The value of EEG in children with chronic headaches
U Kramer1, Y Nevo, M Y Neufeld
1Institute for Child Development, Tel Aviv Medical Center, Tel Aviv University, Israel.
Insights
Electroencephalography (EEG) is not routinely useful for diagnosing pediatric headaches. While epileptic activity was found in some children, EEG offers minimal diagnostic or treatment contribution for chronic headaches in children.
Area of Science:
- Neurology
- Pediatrics
- Diagnostic Imaging
Background:
- Recurrent headaches are common in children.
- Electroencephalography (EEG) is a tool used in neurological evaluations.
Purpose of the Study:
- To determine the diagnostic utility of EEG in pediatric headache evaluation.
- To assess the contribution of EEG to the diagnosis and treatment of chronic headaches in children.
Main Methods:
- Retrospective review of medical records of children with recurrent headaches.
- Analysis of EEG tracings, including epileptic activity and slowing.
- Comparison of EEG findings between migraineurs and other headache types.
Main Results:
- EEG was performed on 82% of 312 children.
- Epileptic activity was detected in 12% of children, with higher incidence in brief headaches.
- Diffuse or focal slowing was found in 8.6%, more common in migraine patients.
Conclusions:
- EEG shows a high incidence of epileptic abnormalities in children with headaches.
- EEG has minimal contribution to the diagnosis and treatment of chronic headaches in children.
- Routine EEG is not recommended for pediatric headache evaluation.
Abstract:
To establish the usefulness of electroencephalography (EEG) as a diagnostic tool in the evaluation of headaches in children, we retrospectively reviewed the records of all children referred to our outpatient neuropediatric clinic because of recurrent headaches. Of 312 children, 257 (82%) underwent EEG tracings: 143 of the children who had had EEG recordings were diagnosed as migraineurs. In 31 (12%) of the children, the EEG revealed epileptic activity. The highest incidence of epileptic EEG activity was found amongst the children with very brief headaches. In 22 (8.6%) of the children, diffuse or focal slowing was detected. The group with migraine headache had a significantly higher incidence of slowing than the group with other types of headaches. There was no correlation between focal EEG abnormalities and brain radioimaging studies or clinical course. We conclude that despite the high incidence of epileptic abnormalities, the contribution of EEG to diagnosis and treatment in children with chronic headache is minimal, and should not be routinely prescribed in these children.