반복되는 두통으로 내원한 소아청소년 환자의 임상양상과 뇌파검사

Clinical Characteristics and Electroencephalogram in Children with Recurrent Headache

Purpose: We compared clinical findings of headaches to find out important characteristics for the differential diagnosis of headaches. We tried to find out specific electroencephalogram (EEG) findings according to the types of primary headache and the relationship between clinical characteristics and EEG findings by analyzing EEGs of migraine. Method: We conducted a retrospective analysis by reviewing medical records of 275 patients who visited the Department of Pediatrics of Korea University Guro Hospital from November 2010 to October 2013. The headaches were classified according to the International Classification of Headache Disorders-II (ICHD- II). EEG was analyzed in relation to the type of headache. Results: 245 (89.1%) were primary headache patients, and 30 (10.9%) were secondary headache patients.There were no differences in the frequencies of abnormal EEG findings according to the type of primary headache (P=0.855), and epileptiform discharge was most common abnormal EEG finding in the primary headache. Comparing the patients with epileptiform discharges to the patients with normal EEG finding in migraine, the patients showing epileptiform discharge were younger (P=0.035) and presented with occipital and atypical (i.e., not pulsating or pressing) headache (P=0.005). Conclusion: History and physical examination are the most important in the diagnosis of headache in children. There were no significant differences in EEG findings among the different types of primary headaches.However,we could find a relationship between clinical features of the migraine and its epileptiform discharge, so more studies correlating EEG findings to clinical features are needed in the future.