Isolated Epileptiform EEG Discharges and Autism
Pediatric Neurology Briefs
Cluster headache is uncommon in childhood. Onset is usually in the second and third decade. A retrospective review of cases attending a pediatric neurology clinic in Bristol, UK, between 2000 and 2005 identified 11 patients (7 male, 4 female) with median age of onset of 8.5 years (range 2-14). Median age at diagnosis was 11.5 years (range 7-17). Eight had episodic and 3 had chronic cluster headache. Most had cranial autonomic activation and agitated movement. (Majumdar A, Ahmed MA, Benton S.
... ed MA, Benton S. Eur J Paediatr Neurol 2008; Dec 22. (Epub ahead of print). Maytal J et al modifications of the IHS criteria for pediatric migraine found that decreasing the length of attacks below 2 to 48 hours would increase the sensitivity of diagnosis, but adding associated autonomic symptoms of facial redness or pallor, while improving sensitivity, also decreased the specificity. The addition of CAS while helpful was not recommended. (Neurology 1997;48:602-607). Perhaps more attention to autonomic symptoms and behavior in diagnosis of children with migraine would be warranted.