Recurrent headaches in 100 children. Electroencephalographic abnormalities and response to phenytoin (Dilantin).

The causes of chronic, recurrent headaches, the electroencephalographic findings and the response to phenytoin (Dilantin) and other medications have been evaluated in 100 children. A history of head injury was reported in 41% and convulsions had occurred in 15%. Electroencephalographic dysrhythmias were severe in 18 and moderate in 27%. Migraine was diagnosed in 42% and tension headaches in 18%; psychogenic factors complicated learning disabilities and minimal brain dysfunction in 21%. Phenytoin controlled migraine in 77% and headaches diagnosed as seizure equivalents in 40%; the response was unrelated to the degree of electroencephalographic abnormality. An abnormal electroencephalogram and response to phenytoin are insufficient criteria for a diagnosis of epilepsy in children with recurrent headaches.