ABSTRACT
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.
Subject(s)
Encephalitis/complications , Encephalitis/surgery , Epilepsy/complications , Epilepsy/etiology , Migraine Disorders/etiology , Adolescent , Anticonvulsants/therapeutic use , Child , Diazepam/therapeutic use , Electroencephalography , Epilepsy/drug therapy , Epilepsy/physiopathology , Humans , Male , Migraine Disorders/drug therapy , Migraine Disorders/physiopathologyABSTRACT
Epidemiological information on symptoms affecting extra-respiratory organs and apparatuses in asthmatic children is scarce. The aim of this study therefore was to evaluate, at a population level, if and what extra-respiratory symptoms are associated with asthma. Two questionnaire-based, cross-sectional surveys were carried out on 1,262 students (651 males; mean age 9.57 years, age-range 6-14 years) in 1992 and on 1,210 students (639 males; mean age 9.02 years, age-range 6-14 years) in 1998, from two elementary and two junior high schools in Rome, Italy. Questionnaires included queries about asthma and its risk factors and extra-respiratory symptoms (headache, restlessness, sleep disturbances, urticaria, itching, and abdominal pain). Of responders, 11.9% (279/2,342) had a history of asthma. After adjustment for gender, family history of atopic disease, low birth weight, early respiratory problems, and damp house, asthma was significantly associated with recurrent abdominal pain (odds ratio [OR] 1.90; 95% confidence interval [CI]: 1.04, 3.16), itching (OR 3.15; 95% CI: 1.75, 5.68), and urticaria (OR 2.52; 95% CI: 1.02, 6.20). Asthma was reported by 10.2% (201/1,962) of children unaffected by this triad, by 20.1% (56/279; OR 2.20) with one of the symptoms, and by 31.6% (12/38; OR 4.04) with two or more symptoms. An emerging characteristic of pediatric asthma in our setting appears to be its association with certain extra-respiratory symptoms (abdominal pain, itching, and urticaria). A global, internistic approach to asthmatic children is increasingly required both in the clinical setting and in future epidemiological studies.
