The value of eeg and spect in the assessment of juvenıle migraine
Year 2024,
Volume: 41 Issue: 3, 537 - 544, 30.09.2024
Tijen Karsli
,
Serap Uysal
,
Ahmet Tevfik Sünter
,
Tarık Başoğlu
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.
Ethical Statement
Ethical Statement: Our study has been perfonmed between 1999 and 2000. Since there is no Ethical Committee before 2011, approval has not been taken for this study (no need for approval).
References
- Judith M. Hocaday and Charles F. Barlow. Headache in Children and Adolescents. In: Stefano Seri, Antonella Cerquiglini. Neurophysiology. University of Rome publications, January 2003. 11-17.
- Lauritzen M, Pathophysiology of the migraine aura: the spreading depression theory. Brain 1994; 117: 199–210.
- Schlake HP, Böttger IG, Grotemeyer KH, Husstedt IW. Brain imaging with 123I-IMP-SPECT in migraine between attacks. Headache. 1989 Jun;29(6):344-9. doi: 10.1111/j.1526-4610.1989.hed2906344.x. PMID: 2788153.
- Soriani S, Feggi L, Battistella PA, Arnaldi C, De Carlo L, Stipa S. Interictal and ictal phase study with Tc 99m HMPAO brain SPECT in juvenile migraine with aura. Headache. 1997 Jan;37(1):31-6. doi: 10.1046/j.1526-4610.1997.3701031.x. PMID: 9046721.
- De Benedittis G, Ferrari Da Passano C, Granata G, Lorenzetti A. CBF changes during headache-free periods and spontaneous/induced attacks in migraine with and without aura: a TCD and SPECT comparison study. J Neurosurg Sci. 1999 Jun;43(2):141-6; discussion 146-7. PMID: 10735768.
- Olesen J, Friberg L, Olsen TS, Iversen HK, Lassen NA, Andersen AR, Karle A. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks. Ann Neurol. 1990 Dec;28(6):791-8. doi: 10.1002/ana.410280610. PMID: 2285266.
- Lauritzen M, Olesen J. Regional cerebral blood flow during migraine attacks by Xenon-133 inhalation and emission tomography. Brain. 1984 Jun;107 ( Pt 2):447-61. doi: 10.1093/brain/107.2.447. PMID: 6609739.
- Battistella PA, Ruffilli R, Dalla Pozza F, Pitassi I, Casara GL, Boniver C, Suppiej A, Bendagli B, Condini A. 99mTc HM-PAO SPECT in pediatric migraine. Headache. 1990 Oct;30(10):646-9. doi: 10.1111/j.1526-4610.1990.hed3010646.x. PMID: 2272814.
- Mirza M, Tutuş A, Erdoğan F, et al. Interictal SPECT with Tc-99m HMPAO studies in migraine patients. Acta Neurologica Belgica. 1998 Jun;98(2):190-194. PMID: 9686279.
- Spina A, Damato V, Losito R, Marzocco P, Narducci P, Zizzo L. Brain SPECT and migraine in childhood. Acta Neurol (Napoli). 1992 Feb;14(1):10-4. PMID: 1580199.
- Lagrèze HL, Dettmers C, Hartmann A. Abnormalities of interictal cerebral perfusion in classic but not common migraine. Stroke. 1988 Sep;19(9):1108-11. doi: 10.1161/01.str.19.9.1108. PMID: 3413808.
- Colamussi P, Giganti M, Cittanti C, Scutellari PN, Monetti VC, Tola MR, Piffanelli A. Significance and usefulness of SPECT with Tc-99m HMPAO in the diagnosis of hemicrania with aura. Radiol Med. 1995 Mar;89(3):324-9. Italian. PMID: 7754129.
- Maini CL, Turco GL, Castellano G, Liboni W, Podio V, Chianale G, Cornaglia G. Cerebral blood flow and volume in symptom-free migraineurs: a SPECT study. Nuklearmedizin. 1990 Nov;29(5):210-4. PMID: 2177553.
- Ferrari MD, Haan J, Blokland JA, Arndt JW, Minnee P, Zwinderman AH, Pauwels EK, Saxena PR. Cerebral blood flow during migraine attacks without aura and effect of sumatriptan. Arch Neurol. 1995 Feb;52(2):135-9. doi: 10.1001/archneur.1995.00540260037013. PMID: 7848120.
- Olesen J, Diener HS. Hemodynamics and Neuroimaging of Migraine. In: J. Olesen. The Headaches. Second Edition, USA, Lippincott Williams and Willkins. 2000: 283-291.
- Levine SR, Welch KM, Ewing JR, Robertson WM. Asymmetric cerebral blood flow patterns in migraine. Cephalalgia. 1987 Dec;7(4):245-8. doi: 10.1046/j.1468-2982.1987.0704245.x. PMID: 3427624.
- Bednarczyk EM, Remler B, Weikart C, Nelson AD, Reed RC. Global cerebral blood flow, blood volume, and oxygen metabolism in patients with migraine headache. Neurology. 1998 Jun;50(6):1736-40. doi: 10.1212/wnl.50.6.1736. PMID: 9633719.
- De Carlo L, Cavaliere B, Arnaldi C, Faggioli R, Soriani S, Scarpa P. EEG evaluation in children and adolescents with chronic headaches. Eur J Pediatr. 1999 Mar;158(3):247-8. doi: 10.1007/s004310051060. PMID: 10094449.
- Kramer U, Nevo Y, Harel S. Electroencephalography in the evaluation of headache patients: a review. Isr J Med Sci. 1997 Dec;33(12):816-20. PMID: 9464351.
- Schoenen J, Thomsen LL. Neurophysiology and autonomic dysfunction in migraine. In: Olesen J. The Headaches. Second Edition, USA, Lippincott Williams and Willkins. 2000: 301-309.
Year 2024,
Volume: 41 Issue: 3, 537 - 544, 30.09.2024
Tijen Karsli
,
Serap Uysal
,
Ahmet Tevfik Sünter
,
Tarık Başoğlu
References
- Judith M. Hocaday and Charles F. Barlow. Headache in Children and Adolescents. In: Stefano Seri, Antonella Cerquiglini. Neurophysiology. University of Rome publications, January 2003. 11-17.
- Lauritzen M, Pathophysiology of the migraine aura: the spreading depression theory. Brain 1994; 117: 199–210.
- Schlake HP, Böttger IG, Grotemeyer KH, Husstedt IW. Brain imaging with 123I-IMP-SPECT in migraine between attacks. Headache. 1989 Jun;29(6):344-9. doi: 10.1111/j.1526-4610.1989.hed2906344.x. PMID: 2788153.
- Soriani S, Feggi L, Battistella PA, Arnaldi C, De Carlo L, Stipa S. Interictal and ictal phase study with Tc 99m HMPAO brain SPECT in juvenile migraine with aura. Headache. 1997 Jan;37(1):31-6. doi: 10.1046/j.1526-4610.1997.3701031.x. PMID: 9046721.
- De Benedittis G, Ferrari Da Passano C, Granata G, Lorenzetti A. CBF changes during headache-free periods and spontaneous/induced attacks in migraine with and without aura: a TCD and SPECT comparison study. J Neurosurg Sci. 1999 Jun;43(2):141-6; discussion 146-7. PMID: 10735768.
- Olesen J, Friberg L, Olsen TS, Iversen HK, Lassen NA, Andersen AR, Karle A. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks. Ann Neurol. 1990 Dec;28(6):791-8. doi: 10.1002/ana.410280610. PMID: 2285266.
- Lauritzen M, Olesen J. Regional cerebral blood flow during migraine attacks by Xenon-133 inhalation and emission tomography. Brain. 1984 Jun;107 ( Pt 2):447-61. doi: 10.1093/brain/107.2.447. PMID: 6609739.
- Battistella PA, Ruffilli R, Dalla Pozza F, Pitassi I, Casara GL, Boniver C, Suppiej A, Bendagli B, Condini A. 99mTc HM-PAO SPECT in pediatric migraine. Headache. 1990 Oct;30(10):646-9. doi: 10.1111/j.1526-4610.1990.hed3010646.x. PMID: 2272814.
- Mirza M, Tutuş A, Erdoğan F, et al. Interictal SPECT with Tc-99m HMPAO studies in migraine patients. Acta Neurologica Belgica. 1998 Jun;98(2):190-194. PMID: 9686279.
- Spina A, Damato V, Losito R, Marzocco P, Narducci P, Zizzo L. Brain SPECT and migraine in childhood. Acta Neurol (Napoli). 1992 Feb;14(1):10-4. PMID: 1580199.
- Lagrèze HL, Dettmers C, Hartmann A. Abnormalities of interictal cerebral perfusion in classic but not common migraine. Stroke. 1988 Sep;19(9):1108-11. doi: 10.1161/01.str.19.9.1108. PMID: 3413808.
- Colamussi P, Giganti M, Cittanti C, Scutellari PN, Monetti VC, Tola MR, Piffanelli A. Significance and usefulness of SPECT with Tc-99m HMPAO in the diagnosis of hemicrania with aura. Radiol Med. 1995 Mar;89(3):324-9. Italian. PMID: 7754129.
- Maini CL, Turco GL, Castellano G, Liboni W, Podio V, Chianale G, Cornaglia G. Cerebral blood flow and volume in symptom-free migraineurs: a SPECT study. Nuklearmedizin. 1990 Nov;29(5):210-4. PMID: 2177553.
- Ferrari MD, Haan J, Blokland JA, Arndt JW, Minnee P, Zwinderman AH, Pauwels EK, Saxena PR. Cerebral blood flow during migraine attacks without aura and effect of sumatriptan. Arch Neurol. 1995 Feb;52(2):135-9. doi: 10.1001/archneur.1995.00540260037013. PMID: 7848120.
- Olesen J, Diener HS. Hemodynamics and Neuroimaging of Migraine. In: J. Olesen. The Headaches. Second Edition, USA, Lippincott Williams and Willkins. 2000: 283-291.
- Levine SR, Welch KM, Ewing JR, Robertson WM. Asymmetric cerebral blood flow patterns in migraine. Cephalalgia. 1987 Dec;7(4):245-8. doi: 10.1046/j.1468-2982.1987.0704245.x. PMID: 3427624.
- Bednarczyk EM, Remler B, Weikart C, Nelson AD, Reed RC. Global cerebral blood flow, blood volume, and oxygen metabolism in patients with migraine headache. Neurology. 1998 Jun;50(6):1736-40. doi: 10.1212/wnl.50.6.1736. PMID: 9633719.
- De Carlo L, Cavaliere B, Arnaldi C, Faggioli R, Soriani S, Scarpa P. EEG evaluation in children and adolescents with chronic headaches. Eur J Pediatr. 1999 Mar;158(3):247-8. doi: 10.1007/s004310051060. PMID: 10094449.
- Kramer U, Nevo Y, Harel S. Electroencephalography in the evaluation of headache patients: a review. Isr J Med Sci. 1997 Dec;33(12):816-20. PMID: 9464351.
- Schoenen J, Thomsen LL. Neurophysiology and autonomic dysfunction in migraine. In: Olesen J. The Headaches. Second Edition, USA, Lippincott Williams and Willkins. 2000: 301-309.