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EEG findings during basilar migraine attacks in children
G P Ramelli1, M Sturzenegger, F Donati
1Department of Paediatrics, Universitäts-Kinderklinik, Inselspital, Berne, Switzerland.
Insights
Basilar migraine (BM) in children can cause EEG abnormalities, including slow wave activity during attacks. These EEG findings resolve over time and should not be mistaken for serious brain-stem lesions.
Area of Science:
- Neurology
- Pediatrics
- Neurophysiology
Background:
- Basilar migraine (BM) is a subtype of migraine characterized by neurological symptoms affecting the brainstem.
- Pediatric basilar migraine requires careful diagnostic evaluation to differentiate from other neurological conditions.
Observation:
- This study reports on four pediatric patients diagnosed with basilar migraine.
- Electroencephalogram (EEG) recordings were performed during acute attacks and during follow-up.
Findings:
- Early EEG (within 4 hours) showed diffuse polymorphic subdelta-delta activity.
- Later EEG (around 16 hours) revealed occipital predominant delta-theta activity.
- All observed EEG abnormalities resolved by the follow-up EEG.
Implications:
- EEG findings in pediatric basilar migraine can mimic structural brain lesions.
- Clinicians must integrate EEG results with clinical presentation to avoid misdiagnosis of brain-stem infarction or inflammation.
- Understanding the transient nature of EEG changes is crucial for accurate diagnosis and management of pediatric basilar migraine.
Abstract:
We present clinical and EEG findings in 4 children with basilar migraine (BM) (three female and one male, age 11 to 13.5 years). All patients had an EEG during the acute attack and a follow-up EEG within 4 to 18 days. In two patients the EEG, done within 4 h of the onset of symptoms (initial stage), showed diffuse polymorphic subdelta-delta activity. In two other children the EEG, performed 16 h after the onset of symptoms, showed delta-theta activity predominant over the occipital regions. Resolution of these abnormalities during follow-up was observed in all patients. We wish to stress the danger of misinterpretation of the slow wave activity in the EEG of patients with BM attacks. Together with the clinical findings and their evolution, EEG results should not be interpreted as a sign of a structural brain-stem lesion, such as infarction or inflammation.