Pediatric Headaches: Diagnostic and Therapeutic Issues

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child Neurology".

Deadline for manuscript submissions: 10 July 2024 | Viewed by 2790

Special Issue Editor


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Guest Editor
Department of Neuroscience and Mental Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
Interests: clinical pediatric neurology; including epilepsy; headache; movement disorders and neuromuscular diseases

Special Issue Information

Dear Colleagues,

Headaches are one of the most frequent causes of admission to the pediatric emergency department or ambulatory clinic. Headaches can be worrisome for patients, their parents and clinicians owing to the variety of underlying etiologies, both benign and serious. A thorough yet focused approach is required in diagnosing and treating children with headaches. However, many clinicians are not familiar with a focused approach to headaches, which can result in difficulty with decision making regarding further testing, such as neuroimaging, and treatment options.

In this Special Issue, we aim to review the clinician’s approach to children with headaches. The Special Issue is organized to address the diagnosis and treatment of common and less common pediatric headaches in clinical practice.

Prof. Dr. Alberto Maria Cappellari
Guest Editor

Manuscript Submission Information

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Keywords

  • children
  • adolescents
  • headache
  • migraine
  • red flags

Published Papers (3 papers)

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Research

12 pages, 1442 KiB  
Article
Pediatric Migraine and Visual Cortical Excitability: A Prospective Observational Study with Sound-Induced Flash Illusions
by Salvatore Di Marco, Laura Pilati, Angelo Torrente, Simona Maccora, Andrea Santangelo, Giuseppe Cosentino, Edvige Correnti, Vincenzo Raieli, Brigida Fierro and Filippo Brighina
Children 2024, 11(4), 394; https://doi.org/10.3390/children11040394 - 26 Mar 2024
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Abstract
The pathophysiological mechanisms underlying migraine are more difficult to investigate in children than in the adult population. Abnormal cortical excitability turns out to be one of the most peculiar aspects of migraine, accounting for the manifestations of migraine attacks. Recently, visual cortical excitability [...] Read more.
The pathophysiological mechanisms underlying migraine are more difficult to investigate in children than in the adult population. Abnormal cortical excitability turns out to be one of the most peculiar aspects of migraine, accounting for the manifestations of migraine attacks. Recently, visual cortical excitability has been explored effectively in adult migraineurs with a technique based on cross-modal audio-visual illusions (with sound-induced flash illusions (SIFIs) being reduced in migraineurs compared to non-migraineur subjects). On such a basis, in this study, we investigated visual cortical excitability in children with migraine using SIFIs using combinations of visual and sound stimuli presented randomly. We evaluated 26 children with migraine without aura and 16 healthy children. Migraineurs did not differ from the age-matched healthy subjects regarding fission or fusion illusions but perceived more flashes in trials of multiple flashes with or without beeps. The higher number of SIFIs in migraineur children compared to adults may be due to a greater propensity of visual stimulation to be driven by auditory stimuli (i.e., acoustic dominance). The increased ability to perceive flashes reveals a hyperfunctional visual cortex, demonstrating that the use of SIFIs is a valid tool for assessing visual cortical responsiveness even in pediatric migraine. Full article
(This article belongs to the Special Issue Pediatric Headaches: Diagnostic and Therapeutic Issues)
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17 pages, 1634 KiB  
Communication
Neuromodulation in Pediatric Migraine using Repetitive Neuromuscular Magnetic Stimulation: A Feasibility Study
by Corinna Börner-Schröder, Magdalena Lang, Giada Urban, Erik Zaidenstadt, Jacob Staisch, Ari Hauser, Iris Hannibal, Kristina Huß, Birgit Klose, Matthias F. Lechner, Nico Sollmann, Mirjam N. Landgraf, Florian Heinen and Michaela V. Bonfert
Children 2023, 10(11), 1764; https://doi.org/10.3390/children10111764 - 30 Oct 2023
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Abstract
Migraine has a relevant impact on pediatric health. Non-pharmacological modalities for its management are urgently needed. This study assessed the safety, feasibility, acceptance, and efficacy of repetitive neuromuscular magnetic stimulation (rNMS) in pediatric migraine. A total of 13 patients with migraine, ≥6 headache [...] Read more.
Migraine has a relevant impact on pediatric health. Non-pharmacological modalities for its management are urgently needed. This study assessed the safety, feasibility, acceptance, and efficacy of repetitive neuromuscular magnetic stimulation (rNMS) in pediatric migraine. A total of 13 patients with migraine, ≥6 headache days during baseline, and ≥1 myofascial trigger point in the upper trapezius muscles (UTM) received six rNMS sessions within 3 weeks. Headache frequency, intensity, and medication intake were monitored using headache calendars; headache-related impairment and quality of life were measured using PedMIDAS and KINDL questionnaires. Muscular involvement was assessed using pressure pain thresholds (PPT). Adherence yielded 100%. In 82% of all rNMS sessions, no side effects occurred. All participants would recommend rNMS and would repeat it. Headache frequency, medication intake, and PedMIDAS scores decreased from baseline to follow-up (FU), trending towards statistical significance (p = 0.089; p = 0.081, p = 0.055). A total of 7 patients were classified as responders, with a ≥25% relative reduction in headache frequency. PPT above the UTM significantly increased from pre- to post-assessment, which sustained until FU (p = 0.015 and 0.026, respectively). rNMS was safe, feasible, well-accepted, and beneficial on the muscular level. The potential to reduce headache-related symptoms together with PPT changes of the targeted UTM may underscore the interplay of peripheral and central mechanisms conceptualized within the trigemino-cervical complex. Full article
(This article belongs to the Special Issue Pediatric Headaches: Diagnostic and Therapeutic Issues)
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6 pages, 453 KiB  
Communication
High CCL2 Levels Detected in CSF of Patients with Pediatric Pseudotumor Cerebri Syndrome
by Jacob Genizi, Lotan Berger, Muhammad Mahajnah, Yulia Shlonsky, Orit Golan-Shany, Azriel Romem, Ayelet Halevy, Keren Nathan, Rajech Sharkia, Abdelnaser Zalan, Aharon Kessel and Rony Cohen
Children 2023, 10(7), 1122; https://doi.org/10.3390/children10071122 - 28 Jun 2023
Viewed by 818
Abstract
Pseudotumor cerebri (PTC) is a disorder characterized by increased intracranial pressure in the absence of a structural lesion or other identifiable cause. Cytokines, which are involved in the regulation of immune responses and inflammation, have been implicated in the pathogenesis of PTC. In [...] Read more.
Pseudotumor cerebri (PTC) is a disorder characterized by increased intracranial pressure in the absence of a structural lesion or other identifiable cause. Cytokines, which are involved in the regulation of immune responses and inflammation, have been implicated in the pathogenesis of PTC. In a prospective, cross-sectional study at three centers in Israel, we analyzed cerebrospinal fluid (CSF) samples from 60 children aged 0.5–18 years, including 43 children with a definitive diagnosis of PTC and a control group of 17 children. Levels of IL-4, IL-10, IL-17, CCL2, CCL7, CCL8, CCL13, BDNF, and IFN-γ were measured using ELISA kits. Levels of CCL2 were significantly higher in the PTC group compared to the control group (p < 0.05), with no other significant differences in the measured cytokines between the two groups. The groups did not differ significantly in clinical presentation, imaging, treatment, or ophthalmic findings. Our findings provide preliminary evidence that CCL2 may be involved in the pathogenesis of PTC and may serve a potential target for therapy in PTC. Full article
(This article belongs to the Special Issue Pediatric Headaches: Diagnostic and Therapeutic Issues)
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