Clinical features and EEG findings in pediatric migraine: A retrospective analysis of 148 patients

• Published in: Cephalalgia reports Vol. 8
• Main Authors: Uyur, Emek, Eldeş Hacıfazlıoğlu, Nilüfer
• Format: Journal Article
• Language: English
• Published: SAGE Publishing 01.08.2025
• ISSN: 2515-8163; 2515-8163
• DOI: 10.1177/25158163251371154

Background Migraine is the most common primary headache disorder in children and adolescents. Abnormal neuronal hyperexcitability is thought to play a role in the pathophysiology of migraine. This study aimed to evaluate the clinical features and EEG (electroencephalogram) findings in pediatric patients with migraine. Methods Between January 2016 and December 2023, the electronic medical records of 3740 patients who presented with headache complaints at the Pediatric Neurology Clinic were reviewed retrospectively. The ICD-10 code (R51) for headache was used to identify the patients. From this group, 172 patients were diagnosed with migraine. A total of 148 patients, aged 6–18, diagnosed with migraine according to the ICDH-3 beta criteria, with complete clinical and EEG records, and followed for at least 6 months, were included in the study. Results Out of the 148 patients, 81 (54.7%) were girls, and the female-to-male ratio was 1.21. The mean age of the patients was 11.6 ± 3.04 years. Twenty (13.5%) patients had migraine attacks with aura. Twenty-seven patients (18.2%) had abnormal EEGs, with 9 showing focal and 18 showing generalized abnormalities. Sixty-six patients (44.6%) have a family history of migraine and/or epilepsy. A statistically significant relationship was found between family history and EEG abnormalities (p = 0.000). Migraine with aura (20/148) showed more EEG abnormalities and a higher incidence of positive family history compared to migraine without aura (p < 0.001). EEG abnormalities were significantly higher in recordings taken during a headache attack (p = 0.000). The rate of starting migraine preventive treatment was higher in patients with abnormal EEGs (21/27). Conclusion Pediatric migraine diagnosis is based on clinical evaluation. In patients with a family history of migraine/epilepsy and those with migraine with aura, especially EEG recording is performed during a headache attack may play a role in the differential diagnosis and in guiding its management EEG, especially in pediatric migraine patients, considering the challenges of expression at a young age, may be used more frequently in follow-up.