Boćkowski L, Sobaniec W, Smigielska-Kuzia J, Kułak W, Sołowiej E
Department of Pediatric Neurology, Medical University of Białystok, SP DSK, ul. Waszyngtona 17, 15-274 Białystok, Poland.
Rocz Akad Med Bialymst. 2003;48:154-7.
Studies of the visual evoked potentials (VEP) in migraine have yielded contradictory results. Several investigators suggested that VEP may be helpful test in diagnosis of a child with headache. The aim of our study was to compare interictal pattern-reversal visual evoked potentials (PR-VEP) in children and adolescents with migraine and tension-type headaches and to evaluate VEP parameters in migraine with and without aura.
The study was carried out in 93 children and adolescents aged 7-18 years with attack headaches.
51 children had diagnosed migraine. In this group 30 children (59%) had migraine without aura (MO), 12 children (23.5%) migraine with aura (MA) and 9 (17.5%) patients other variants of migraine (MV): hemiplegic, ophthalmoplegic, basilar. In control group 42 children were classified as tension-type headaches. All children had PR-VEP performed in headache-free period, without prophylactic treatment. The P100 mean latency was significantly longer in migraine than in tension-type headache. Amplitudes N1-P100 and P100-N2 were significantly larger in migraneurs compared with tension-type headache. The mean amplitudes of N1-P100 and P100-N2 were significantly lower in MA compared with group MO. There were no statistically significant differences of other PR-VEP parameters between MA, MO, MV. If we compare individual results of each patient with migraine with mean value +/- 2 standard deviations (SD) of tension-type headaches group, only 25% have VEP abnormalities of latency or amplitude above 2SD value in tension-type headache group.
The diagnosis of migraine in children actually remains predominantly based on medical history, due to low sensitivity and specificity of electrodiagnostic tests in headaches. However PR-VEP may support the diagnosis of migraine in some cases. VEP could be also helpful method in studying the pathogenesis of different forms of migraine. VEP abnormalities in migraine can be related to a cortical spreading depression and a central neurotransmitter alterations.
偏头痛视觉诱发电位（VEP）的研究结果相互矛盾。一些研究者认为VEP可能有助于诊断儿童头痛。本研究的目的是比较偏头痛和紧张型头痛儿童及青少年发作间期模式翻转视觉诱发电位（PR-VEP），并评估有无先兆偏头痛的VEP参数。
对93例7-18岁发作性头痛的儿童及青少年进行了研究。
51例儿童被诊断为偏头痛。该组中，30例儿童（59%）为无先兆偏头痛（MO），12例儿童（23.5%）为有先兆偏头痛（MA），9例（17.5%）为其他偏头痛类型（MV）：偏瘫型、眼肌麻痹型、基底型。对照组42例儿童被归类为紧张型头痛。所有儿童均在无头痛期进行PR-VEP检查，且未进行预防性治疗。偏头痛患者的P100平均潜伏期显著长于紧张型头痛患者。与紧张型头痛患者相比，偏头痛患者的N1-P100和P100-N2波幅显著更大。与MO组相比，MA组的N1-P100和P100-N2平均波幅显著更低。MA、MO、MV组之间其他PR-VEP参数无统计学显著差异。若将每位偏头痛患者的个体结果与紧张型头痛组平均值±2标准差（SD）进行比较，紧张型头痛组中仅有25%的患者VEP潜伏期或波幅异常超过2SD值。
由于电诊断检查在头痛方面的敏感性和特异性较低，儿童偏头痛的诊断实际上仍主要基于病史。然而，PR-VEP在某些情况下可能支持偏头痛的诊断。VEP也可能是研究不同形式偏头痛发病机制的有用方法。偏头痛中的VEP异常可能与皮质扩散性抑制和中枢神经递质改变有关。
