Johns Hopkins University, Baltimore, MD, USA.
Neurology. 2012 Jul 31;79(5):468-73. doi: 10.1212/WNL.0b013e3182617113. Epub 2012 Jun 27.
Migraine and epilepsy are 2 of the most common neurologic disorders in children. In this cross-sectional study we investigated a population of children with epilepsy to determine if children with a greater seizure burden or certain epilepsy syndromes had a higher risk of migraines. We also examined how often migraine is addressed and treated in a pediatric epilepsy cohort.
Between January 2010 and March 2011 we distributed questionnaires regarding headache symptoms and treatment to consecutive children with epilepsy seen in clinic at Johns Hopkins Hospital (400 children were studied). Records were subsequently reviewed for seizure type, age at onset, and treatment.
The prevalence of migraine in our pediatric epilepsy population was 25%, which is greater than reported for children without epilepsy (3%-23%). Migraine was more prevalent in children ≥10 years (p = 0.0009), children with benign epilepsy with centrotemporal spikes (BECTS) (p = 0.003), and children with juvenile myoclonic epilepsy (JME) (p = 0.008). Migraine onset was more likely to have occurred after epilepsy was diagnosed (p = 0.0002), but was not more prevalent in those with intractable epilepsy. Only 50% of patients with weekly or greater migraines had documented discussions regarding headaches with their neurologist.
Migraine was comorbid in one-quarter of children with epilepsy in a tertiary care center. Children who were older or who had BECTS or JME were more likely to have migraines. Migraines were infrequently addressed within the neurology clinic. It is imperative to address comorbid migraine in treating children with epilepsy.
偏头痛和癫痫是儿童中最常见的两种神经系统疾病。在这项横断面研究中，我们调查了一组癫痫患儿，以确定癫痫发作次数较多或特定癫痫综合征的患儿偏头痛风险是否更高。我们还检查了偏头痛在儿科癫痫患者群体中被诊断和治疗的频率。
2010 年 1 月至 2011 年 3 月，我们向在约翰霍普金斯医院诊所就诊的连续癫痫患儿分发了有关头痛症状和治疗的问卷（共研究了 400 名患儿）。随后，我们回顾了记录中的癫痫发作类型、发病年龄和治疗情况。
我们儿科癫痫患者群体中偏头痛的患病率为 25%，高于无癫痫患儿（3%-23%）。≥10 岁的儿童（p = 0.0009）、良性癫痫伴中央颞区棘波（BECTS）患儿（p = 0.003）和青少年肌阵挛性癫痫（JME）患儿（p = 0.008）偏头痛的患病率更高。偏头痛的发病更可能在癫痫确诊后（p = 0.0002），但在耐药性癫痫患儿中并不更常见。每周或更频繁偏头痛的患者中，仅有 50%的患者与神经科医生讨论过头痛问题。
在一家三级保健中心，四分之一的癫痫患儿同时患有偏头痛。年龄较大的儿童或患有 BECTS 或 JME 的儿童更可能患有偏头痛。偏头痛在神经病学诊所中很少被提及。在治疗癫痫患儿时，必须解决偏头痛的共病问题。
