1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-9-57 10.15844/pedneurbriefs-9-8-1 Headache Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant EEG in Headache Evaluation http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 08 1995 01 06 2016 9 8 57 58 Copyright: © 1995 The Author(s) 1995 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The utility of the electroencephalogram in the evaluation of patients presenting with headache: A review of the literature

A literature review of articles published between 1941 and 1994 was used to determine the utility of the electroencephalogram in the evaluation of patients with headache and the results are reported from the Departments of Neurology, Lackland AFB, TX, and Andrews AFB, MD.

 Headache Atypical Migrainous Auras Phenytoin

A literature review of articles published between 1941 and 1994 was used to determine the utility of the electroencephalogram in the evaluation of patients with headache and the results are reported from the Departments of Neurology, Lackland AFB, TX, and Andrews AFB, MD. EEG findings that occurred more frequently in headache patients than in controls were as follows: generalized or focal slowing, hyperventilation-induced high-voltage slowing, excessive fast activity, epileptiform discharges, prominent photic driving, and differences in symmetry and frequencies of alpha rhythm. Two studies showed an increased prevalence of 14 & 6 positive spikes in the EEGs of children with migraine. One author suggested that headaches of children whose EEGs demonstrated epileptiform activity would respond best to anticonvulsants. In well controlled studies, a prominent photic driving response at high flash rates (the “H-response”) was the only abnormality distinguishing headache patients from those without headache and migraine from other headache types. Clinical criteria were of greater diagnostic value than the EEG in identifying headache subtypes, including those with structural lesions. [1]

COMMENT. The authors conclude that the EEG is not indicated in routine evaluations of patients presenting with headache. However, they do recommend an EEG in patients with headache and symptoms suggestive of seizures and in those with atypical migrainous auras or episodic loss of consciousness. In one article not cited by the authors, 77 percent of 30 children with migraine benefited from treatment with the anticonvulsant, phenytoin. Response to phenytoin was not correlated with an abnormal EEG In 13 with abnormal and 17 with normal EEGs, the beneficial response rates were 61% and 88%, respectively. [2]

 Gronseth GS Greenberg MK The utility of the electroencephalogram in the evaluation of patients presenting with headache: A review of the literature Neurology 1995 Jul 45 7 1263 1267 10.1212/WNL.45.7.1263 7617180 Millichap JG Recurrent headaches in 100 children. Electroencephalographs abnormalities and response to phenytoin (Dilantin) Child’s Brain 1978 4 95 104 639603