Abstracts

An association between Rolandic epilepsy and migraine headache has been suggested in previous case series (Bladin, 1987), and controlled studies are conflicting (Santucci, 1985;Giroud, 1989). It has further been suggested that the two diagnoses share etiological background. We therefore tested the hypothesis that migraine headaches are over-represented in children with Rolandic epilepsy., We performed an unmatched case-control study. We collected 44 cases of strictly defined Rolandic epilepsy with oro-facial seizures, median age 9 years, sex ratio 3:2, M:F from pediatric neurology clinics. We collected 92 control children lacking a primary brain diagnosis, median age 9 years, from other subspecialty clinics at the same hospitals. We made a clinical diagnosis of migraine using features in the history that include those required for the International Headache Society criteria, but with modifications for childhood as proposed by Maytal et al 1997. We calculated odds ratios of association, adjusted for age and sex, using multiple logistic regression., 17% of cases and 17% of controls had a clinical diagnosis of migraine without aura. No subject was diagnosed with other migraine variants. When adjusted for age and sex, the odds ratio was 0.94 (95%CI: 0.57-1.52)., The prevalence of migraine in controls was comparable to that reported in meta-analysis estimates (Scher, 1999). The prevalence of migraine in Rolandic epilepsy cases is no different than in controls without a primary brain diagnosis. Our finding of no association is in agreement with a previous controlled study (Santucci, 1985). In contrast, previous uncontrolled reports have suggested that migraine occurs in 62-80% of children with Rolandic epilepsy. Our results suggest that previous reports may have overestimated the prevalence of migraine in Rolandic epilepsy patients, and hence concluded an association. Although our findings do not support the idea that migraine is over-represented in Rolandic epilepsy, this does not exclude the possibility of an association with other focal epilepsies, or the possibility that shared etiological mechanisms pertain for migraine and epilepsy., (Supported by Epilepsy Foundation.; Partnership for Pediatric Epilepsy.; National Institutes of Health NS 047530.)