Migraine triggered by epileptic discharges in a Rasmussen's encephalitis patient after surgery.
After 2years from disconnective surgery for Rasmussen's encephalitis, a child, 9years old, began to present severe migraine attacks, lateralized to the operated side, lasting 1-2days. Video/EEG recordings during two different migraine attacks, with an interval of 6months from each other, showed, in both recordings, subsequent ictal discharges over the affected and disconnected hemisphere. Migraine and ictal discharges in both occasion disappeared with diazepam i.v. The EEGs performed during migraine-free period, on the contrary, showed very rare and mild subclinical ictal discharges. Although a casual relationship could not be excluded, a pure neuronal pathogenetic mechanism can be suggested, mediated by post- and inter-ictal cortical depression.
Fusco
Lucia
L
Division of Neurology, Bambino Gesù Children's Hospital, Rome, Italy. lucia.fusco@opbg.net
Specchio
Nicola
N
Ciofetta
Giancarlo
G
Longo
Daniela
D
Trivisano
Marina
M
Vigevano
Federico
F
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D003975:Diazepam / Q000627:therapeutic use; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications* / Q000601:surgery*; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology
D000927:Anticonvulsants; D003975:Diazepam