The value of EEG and SPECT in the assessment of juvenile migraine

Abstract

Despite the cause of migraine headaches is not exactly understood, cerebral blood flow studies revealed new insights in the pathophysiology of migraine. The data from Single Photon Emission Computerized Tomography studies in juvenile group diagnosed according to the HIS criteria are very rare, also there are limited number of studies in literature in which SPECT and EEG findings are combined. This study aimed to evaluate changes in regional cerebral blood flow and EEGs in juvenile patients suffering from migraine, also to investigate the relationship between SPECT and EEG in respect to comparison of each other, the frequency of attacks and response to the treatment. We grouped 20 children with migraine, 9 with aura, 11 without aura, and obtained SPECT and EEG’s in ictal and interictal periods. All patients received Propranolol after the studies were performed. Regional cerebral and cerebellar perfusion was evaluated both visually and semiquantitatively. In the study, visual observation of SPECT revealed that perfusion defect was found 88% for ictal, 55% for interictal period and 55% for ictal, 18% for interictal period in patients with and without aura, respectively. The corticocerebellar ratios obtained semiquantitativly revealed significant differences between ictal and interictal periods in patients without aura, ictal periods in patients with and without aura, interictal periods in patients with and without aura. EEG findings were not significant. All patients who received therapy recovered well. Overall, SPECT can be used as an additional test for diagnosis of migraine because it is useful for visualization of perfusion defect especially in ictal and interictal periods with aura, and in ictal period without aura in childhood. These finding suggest that the idea of the origins of migraines with or without aura might be similar. It is necessary to investigate in large series in order to clarify the pathogenesis of the disease further.