Polysomnographic findings in children with headaches.

Although previous studies suggested a relationship between headache and sleep disturbances, polysomnographic findings in children with headache are rarely described. We investigated polysomnographic findings in children with headaches, and correlated them with headache type and severity, body mass index, and medical treatment. Analysis of polysomnographic findings of 90 children with migraine (60), chronic migraine (11), tension headache (6), and nonspecific headache (13) indicated that sleep-disordered breathing was more frequent among children with migraine (56.6%) and nonspecific headache (54%) vs chronic migraine (27%). Tension headache was not associated with sleep-disordered breathing. In the nonspecific headache group, children with sleep-disordered breathing had higher body mass indexes (P = 0.008). Severe migraine and chronic migraine were associated with shorter sleep time, longer sleep latency, and shorter rapid eye movement and slow-wave sleep. Fifty percent of children with tension headache manifested bruxism vs 2.4% of children with nontension headache (odds ratio, 1.95; 95% confidence interval, 1.2-4.34). Our results support an association between migraine and sleep-disordered breathing, and between tension headache and bruxism, in children. Moreover, disrupted sleep architecture with reduced rapid eye movement and slow-wave sleep in severe and chronic migraine headaches may support an intrinsic relationship between sleep and headache disorders

Aggravation of seizures and/or EEG features in children treated with oxcarbazepine monotherapy.

PURPOSE: Exacerbation of epilepsy may occur following initiation of therapy with antiepileptic drugs (AEDs). The aim of this study is to analyze the clinical and EEG characteristics of a group of pediatric patients with worsening of seizures and/or EEG deterioration while on oxcarbazepine (OXC). METHODS: A retrospective analysis of a clinical database was performed to identify patients with epilepsy treated with OXC over the past 3 years. History, neurological examination, and EEG findings were reviewed to identify any who had developed exacerbation of seizures or new abnormalities on EEG. RESULTS: Of 290 patients on OXC, we identified 12 patients with new onset seizures, all with initial normal neurological exam and normal EEG, who developed either worsening of preexisting seizures, new seizure types, and/or EEG deterioration following introduction of OXC monotherapy. EEG changes were primarily characterized by new onset of generalized epileptiform activity not reported on the initial baseline EEG. Following substitution of OXC with a broad spectrum AED, significant improvement of seizure control and improvement in the EEG was observed. CONCLUSIONS: These findings suggest that OXC can aggravate seizures and/or worsen EEG features in children. Following initiation of therapy with OXC, monitoring of patients with follow-up EEGs may be important, especially in patients who do not show adequate response to therapy