In 2004, the revised International Classification of Headache Disorders (ICHD-II) was published. This study evaluates: (1) the results obtained from applying ICHD-II to children with primary headaches to distinguish between migraine without aura (MO) and tension-type headache (TTH); and (2) the results obtained from introducing modifications of the classification criteria for MO as suggested by various authors. There were 200 participants (93 males, 107 females; age range 3-17y, mean 9y 8mo [SD 2y 7mo]). According to the ICHD-II, MO compared with TTH was characterized by: higher intensity of pain; higher frequency of associated symptoms; and higher number of precipitating factors. The significant difference found between patients with MO/probable MO and those with TTH/probable TTH for the variables used in the ICHD-II shows that these variables describe the two forms well. However, 15.5% of children proved to be unclassifiable, mainly because they could not give information for some criteria; other reasons for this were too short a duration of episodes and the possible overlap of criteria describing probable MO and probable TTH. The frequency of one variable, pulsating pain, significantly increased with age. Reduction of duration to 1 hour for MO produced a statistically non-significant increase in the number of children with MO. Behaviour during attacks was found to be simple to apply in evaluating intensity and therefore was introduced as a new criterion. Severe intensity was related to MO, whereas moderate or low-intensity was related to TTH.

The aim of this study is to analyze the graphic features and the clinical significance of the focal interictal paroxysmal abnormalities (FIPA) which can be found in the EEG of patients with typical absences, on the basis of 29 personal cases. The children (15 female; mean age at the first evaluation=8.2 years, range 4.8-14.3 years) were particularly selected, because they only showed absence seizures. In all subjects the ictal clinical and EEG features were typical for childhood absence epilepsy (CAE). The interictal EEG showed a normal background activity in all children and in 11 patients the presence of FIPA specially on frontal areas. The graphic aspects of FIPA and their spatial and temporal variability, often in the same subject, were in agreement with a functional form. Furthermore the excellent response to valproic acid and ethosuximide, with a complete seizure control also in the follow-up in 26 among 28 treated children, confirms the opinion that our cases are affected by a typical form of CAE. In conclusion FIPA probably are not uncommon in typical idiopathic CAE and their presence does not seem to change the benign prognosis. There is a relationship between our data and the experimental models proposed in the literature.