Effect of Seizure Clustering on Epilepsy Outcome

J Gordon Millichap
2008 Pediatric Neurology Briefs  
rated as severe in the majority, and the mean duration of an attack was 17 min. Cranial autonomic features, at least one required by IHS classification, involved lacrimation in 87%, conjunctival injection in 68%, rhinorrhea in 58%, and ptosis in 54%. Agitation or restlessness occurred in 80%. All patients responded to indomethacin, a sine qua non for paroxysmal hemicrania. MRI or CT scan obtained in 25 (80%) patients was normal in 16 (64%) and showed abnormalities in 9 (36%). Abnormal scans
more » ... Abnormal scans included vascular loop compressing the trigeminal nerve, ophthalmic A-V malformation, sphenoid wing meningioma, and ischemic lesions in basal ganglia and pons. The authors suggest that the IHS revise the diagnostic criteria for paroxysmal hemicrania to include a wider location for pain, and a more inclusive range of autonomic features. An indomethacin test should be given to any patient with lateralized discrete attacks of head pain with associated cranial autonomic symptoms. Brain
doi:10.15844/pedneurbriefs-22-5-6 fatcat:p67wfh5ezfa63db5npm36dchni