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Etiological classification of chronic headache in children and their electroencephalographic features
1Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Insights
Seizure headache is a common diagnosis in children experiencing chronic headaches, often showing abnormal electroencephalogram (EEG) results. These headaches respond well to anticonvulsant medications.
Area of Science:
- Pediatric Neurology
- Clinical Neuroscience
- Epileptology
Background:
- Chronic headaches are a frequent concern in pediatric neurology referrals.
- Distinguishing between headache types, such as seizure headache and migraine, is crucial for effective treatment.
- Electroencephalography (EEG) plays a role in diagnosing neurological conditions presenting with headaches.
Purpose of the Study:
- To classify headache types in children referred to a pediatric neurology clinic.
- To evaluate the electroencephalographic (EEG) findings in different pediatric headache classifications.
- To assess the efficacy of anticonvulsant treatment for seizure headache in children.
Main Methods:
- Retrospective analysis of 215 children (aged 3-16) with chronic or severe headaches.
- Classification of headaches based on clinical presentation and diagnostic criteria.
- Electroencephalogram (EEG) recording and interpretation for all participants.
- Evaluation of treatment response to anticonvulsants in patients diagnosed with seizure headache.
Main Results:
- Seizure headache was the most common type (27.0%), followed by migraine (22.3%).
- Abnormal or borderline EEG findings were significantly higher in seizure headache patients (75.9% and 24.1%) compared to migraine patients (8.3% and 8.3%).
- Patients with seizure headache and abnormal or borderline EEGs showed good response to anticonvulsants (87.9% and 55.6% respectively).
- Orthostatic dysregulation cases (7) presented with normal EEGs.
Conclusions:
- Seizure headache is a prevalent diagnosis among children with chronic headaches.
- EEG abnormalities are common in pediatric seizure headache.
- Anticonvulsant therapy is an effective treatment for seizure headache in children, particularly those with abnormal or borderline EEG findings.
Abstract:
Classification and electroencephalographic studies were based on 215 children with chronic headache ranged in age from 3 to 16 years (9.53 +/- 2.86 years old) who were referred to the Pediatric Neurology Clinics of National Taiwan University Hospital due to chronic or severe headache from December 1989 to December 1992. The most common type of headache was seizure headache which constituted 27.0% of all these cases. Migraine headache accounted for 22.3%. The abnormal and borderline electroencephalogram (EEG) rate in seizure headache patients were 75.9% and 24.1% respectively. Comparing the results of migraine patients were 8.3% and 8.3% respectively. Seven cases have been diagnosed as orthostatic dysregulation clinically. All of them presented normal EEG. The response of seizure headache to anticonvulsants was good in the patients with abnormal (87.9%) and borderline EEG (55.6%). We conclude that seizure headache is not uncommon in children and it responses good to anticonvulsants.