Pediatric neurology最新文献

{"title":"Editorial Board and Masthead","authors":"","doi":"10.1016/S0887-8994(25)00155-9","DOIUrl":"10.1016/S0887-8994(25)00155-9","url":null,"abstract":"","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"168 ","pages":"Pages A1-A2"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Year in Review: 2024","authors":"","doi":"10.1016/S0887-8994(25)00163-8","DOIUrl":"10.1016/S0887-8994(25)00163-8","url":null,"abstract":"","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"168 ","pages":"Pages 112-116"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and Clinical Features of SLC2A1-Related Paroxysmal Exercise-Induced Dyskinesia","authors":"Jiao-Jiao Xu MMed ,&nbsp;Yu-Lan Chen MD, PhD ,&nbsp;Hao Yu MD, PhD ,&nbsp;Dian-Fu Chen PhD ,&nbsp;Hong-Fu Li MD, PhD ,&nbsp;Zhi-Ying Wu MD, PhD","doi":"10.1016/j.pediatrneurol.2025.06.006","DOIUrl":"10.1016/j.pediatrneurol.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Paroxysmal exercise-induced dyskinesia (PED) is a rare movement disorder characterized by choreoathetosis and dystonia triggered by sustained exercise, commonly affecting the lower extremities. PED is an autosomal dominant disorder genetically linked to mutations in the <em>SLC2A1</em> gene. The transmembrane protein Glut1, encoded by the <em>SLC2A1</em> gene, can transport glucose from blood to the brain. This study aimed to characterize the genetic and clinical features of <em>SLC2A1</em>-related PED.</div></div><div><h3>Methods</h3><div>We reported two Chinese PED families presenting with involuntary movements after prolonged exercise. Whole-exome sequencing was performed on two probands, and cosegregation analysis was subsequently carried out in available family members. Additionally, we summarized and analyzed the genetic and clinical features of <em>SLC2A1</em>-related PED by retrieving information from the literature.</div></div><div><h3>Results</h3><div>Genetic testing identified two missense mutations in <em>SLC2A1</em> in these families, including a known disease-causing mutation, c.997C&gt;T (p.R333W), and a novel mutation, c.823G&gt;C (p.A275P). Upon review of the literature, mutations in certain regions of the Glut1 protein, particularly in transmembrane segments 3, 4, 5, 7, and 8, together with the intracellular domain, were more frequently seen in PED. Among the various types of epilepsy, absence seizures were the most common in patients with PED. Furthermore, familial PED had a later onset and a higher cerebrospinal fluid/blood glucose ratio. Patients with missense mutations exhibited a later onset than those with truncated mutations.</div></div><div><h3>Conclusions</h3><div>Our study identified a new disease-causing mutation and, through an extensive literature review, provided a detailed genetic and clinical description of PED associated with <em>SLC2A1</em> mutations.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 31-37"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Cord Stroke in the Pediatric Population: A Clinical Overview","authors":"Amr Elgehiny MD ,&nbsp;Matthew Wright MD ,&nbsp;Lakshmi Srivaths MD ,&nbsp;Sishir Mannava MD ,&nbsp;Shaikha AlQahtani MD ,&nbsp;Jiasen He MD ,&nbsp;Daniel Davila-Williams MD ,&nbsp;Stuart Fraser MD","doi":"10.1016/j.pediatrneurol.2025.06.002","DOIUrl":"10.1016/j.pediatrneurol.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Spinal cord stroke is a rare but serious condition in the pediatric population, with limited data available. We present a series of 6 pediatric cases to review their clinical presentation, magnetic resonance imaging (MRI) findings, etiology, risk factors, management, and outcomes.</div></div><div><h3>Methods</h3><div>A descriptive analysis was conducted following institutional review board approval, focusing on 6 pediatric patients previously identified by the authors.</div></div><div><h3>Results</h3><div>The median age at presentation was 10 years, with diverse clinical presentations including back, neck, or shoulder pain and hemiplegia; one patient presented with quadriplegia. MRI findings demonstrated distinct infarction patterns, and thrombophilia evaluations were negative in all cases. Treatment was primarily supportive. Four patients received prophylactic aspirin. Follow-up revealed that 3 patients were ambulatory, whereas 3 exhibited persistent motor deficits, and 2 had a neurogenic bladder.</div></div><div><h3>Conclusion</h3><div>Spinal stroke in children is rare and often idiopathic, with fibrocartilaginous embolism frequently suggested but rarely confirmed. MRI was crucial for diagnosis, and thrombophilia evaluation is usually recommended in pediatric stroke, including spinal stroke, although no thrombophilia cases were found. Treatment was supportive, with steroids used for suspected inflammation and prophylactic aspirin administered in some cases. Long-term outcomes varied, with some patients experiencing substantial recovery and others showing persistent deficits, highlighting the importance of individualized rehabilitation.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 38-42"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attenuated Clinical Forms of Tubulinopathies in Children and Adults: A Series of 24 Individuals","authors":"Meghane Durizot MD ,&nbsp;Lydie Burglen MD, PhD ,&nbsp;Catherine Garel MD, PhD ,&nbsp;Eléonore Blondiaux MD, PhD ,&nbsp;Audrey Riquet MD ,&nbsp;Valentine Floret MD ,&nbsp;Vincent Desportes MD, PhD ,&nbsp;Maria Häänpaa MD, PhD ,&nbsp;Maria Irene Valenzuela MD ,&nbsp;Anna Maria Pinto MD, PhD ,&nbsp;Alessandra Renieri MD, PhD ,&nbsp;Michiel Vanneste MD ,&nbsp;Koen Devriendt MD, PhD ,&nbsp;Liesbeth de Waele MD, PhD ,&nbsp;Lucie Guilbaud MD, PhD ,&nbsp;Jean-Marie Jouannic MD, PhD ,&nbsp;Madeleine Harion MD ,&nbsp;Thierry Billette de Villemeur MD, PhD ,&nbsp;Diana Rodriguez MD, PhD ,&nbsp;Emmanuelle Lacaze MD ,&nbsp;Stéphanie Valence MD, PhD","doi":"10.1016/j.pediatrneurol.2025.06.003","DOIUrl":"10.1016/j.pediatrneurol.2025.06.003","url":null,"abstract":"<div><div><em>Background</em>: Tubulinopathies are neurodevelopmental disorders caused by pathogenic variants in tubulin-encoding genes, typically presenting with intellectual disability (ID), epilepsy, motor impairments, and distinct brain malformations. While most cases are de novo and severe, recent reports suggest the existence of milder imaging and clinical phenotypes, including familial cases with attenuated symptoms.</div><div><em>Methods:</em> Through international collaboration, clinical, imaging, and molecular data were collected from 24 individuals (≥4 years old) across 16 families with pathogenic or likely pathogenic variants in TUBA1A, TUBB2B, TUBB3, TUBB, or TUBB2A. Patients were selected based on absence of ID and availability of brain MRI. Genetic inheritance patterns and genotype–phenotype correlations were analyzed.</div><div><em>Results:</em> Fifteen patients were identified through fetal or pediatric imaging and nine through familial investigations. No cases exhibited severe cortical gyration anomalies. TUBB3 was the most frequently mutated gene (12/24, 50%), and 7 out of 14 total variants were inherited. Two recurrent variants, TUBB3 p.(Pro357Leu) and TUBB p.(Asn52Ser), were associated with non-ID phenotypes in both the current cohort and literature.</div><div><em>Conclusions:</em> This study broadens the spectrum of tubulinopathies to include mild imaging phenotypes with attenuated clinical features in children and adults. Absence of major cortical malformations, inherited mutations, and specific genetic variants may serve as favorable prognostic markers. These findings have important implications for genetic counseling, particularly in prenatal cases.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 49-57"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Febrile Seizures and Sudden Death Risk: A Case-Control Analysis","authors":"Laura Gould MSc ,&nbsp;Steven Friedman MS ,&nbsp;Thomas Wisniewski MD ,&nbsp;Orrin Devinsky MD","doi":"10.1016/j.pediatrneurol.2025.06.004","DOIUrl":"10.1016/j.pediatrneurol.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Febrile seizures occur in 3%-4% of US children aged six months to five years and are considered benign. However, sudden unexplained death in childhood is associated with 10 times increase in febrile seizures. We assessed the characteristics of children with febrile seizure and sudden death to identify factors that confer increased sudden death risk.</div></div><div><h3>Methods</h3><div>We conducted a case-control analysis of children with febrile seizure and subsequent sudden death versus living controls from December 2021 to June 2023 through an ∼10-minute anonymous online survey. We enrolled parents of children, living or deceased, whose child had experienced a febrile seizure from age six months to six years. Subjects were excluded if the child had an afebrile seizure or parents had not witnessed a febrile seizure. Demographic characteristics, parasomnias, and febrile seizure features were analyzed.</div></div><div><h3>Results</h3><div>A total of 381 completed surveys were received; 53 (14%) cases of febrile seizure with sudden death and 328 (86%) living controls. Cases reported febrile seizure onset &gt;2 months earlier (<em>P</em> = 0.013) and reported developmental concerns (odds ratio [OR] = 2.32, 95% confidence interval [CI] [1.14, 4.71], <em>P</em> = 0.03), less frequent night awakenings (OR = 0.34, 95% CI [0.18, 0.65], <em>P</em> = 0.001), and less restless sleep (OR = 0.37, 95% CI [0.16, 0.85], <em>P</em> = 0.02). Cases were also less likely to drool (OR = 0.442, 95% CI [0.218, 0.900], <em>P</em> = 0.032) or be unresponsive for more than one minute (OR = 0.45, 95% CI [0.238, 0.854], <em>P</em> = 0.021).</div></div><div><h3>Conclusions</h3><div>We report novel associations of febrile seizure and sudden death related to age, development, sleep, and observed ictal features. Anonymous survey methodology cannot exclude ascertainment bias and any related potential effect on results. Our findings suggest that impaired arousal mechanisms may increase risk of death in subjects with febrile seizure.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 26-30"},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Same-Day Approach for Combined Intravitreal and Intracerebroventricular Enzyme Replacement Therapy to Prevent Retinal Disease Progression in Children With Neuronal Ceroid Lipofuscinosis Type 2","authors":"David L. Rogers MD ,&nbsp;Jill E. Blind PharmD, CCRP ,&nbsp;Troy Kienzle PharmD, MS ,&nbsp;Emily De Los Reyes MD ,&nbsp;Thomas A. Mendel MD, PhD ,&nbsp;Catherine O. Jordan MD","doi":"10.1016/j.pediatrneurol.2025.06.007","DOIUrl":"10.1016/j.pediatrneurol.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Classic late infantile neuronal ceroid lipofuscinosis (CLN2) is caused by a biallelic mutations of the <em>TPP1</em> gene. Vision loss begins around age four years, resulting in blindness by age seven to ten years. Intracerebroventricular cerliponase alfa (Brineura; BioMarin) is indicated to slow the loss of ambulation in pediatric patients with CLN2. However, treated children continue to experience visual loss. Intravitreal cerliponase alfa allows the enzyme to target tissues in the eye, offering a treatment option.</div></div><div><h3>Methods</h3><div>We developed a pathway for same-day administration of both intravitreal and intracerebroventricular cerliponase alfa using a preparation technique that takes advantage of the overfill in the vial.</div></div><div><h3>Results</h3><div>The intravitreal injection of cerliponase alfa is given every 4 weeks. The patient arrives and is registered for both procedures. Sterile technique is used to compound the intracerebroventricular infusion and the intravitreal injections. The intravitreal injection is performed under anesthesia using sterile technique in each eye. The dose of cerliponase alfa injected is 0.2 mg diluted in 0.05 mL of artificial cerebrospinal fluid. The intracerebroventricular infusion is then administered per standard protocol in the infusion center.</div></div><div><h3>Conclusions</h3><div>We believe our pathway can be applied at all centers that are currently administering intracerebroventricular cerliponase alfa and that have the ophthalmologic expertise available to administer intravitreal injections.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 1-3"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Single Session of Transcranial Direct Current Stimulation on Attention in Pediatric Acquired Brain Injury: Characterizing Interindividual Structural and Functional Network Response Variability","authors":"Athena Stein PhD, MPH ,&nbsp;Kevin A. Caulfield PhD ,&nbsp;Mervyn Singh PhD ,&nbsp;Justin Riddle PhD ,&nbsp;Maximilian A. Friehs PhD ,&nbsp;Michael P. Craven PhD ,&nbsp;Madeleine J. Groom PhD ,&nbsp;Kartik K. Iyer PhD ,&nbsp;Karen M. Barlow PhD, MSc, MBChB, MRCPCH","doi":"10.1016/j.pediatrneurol.2025.06.005","DOIUrl":"10.1016/j.pediatrneurol.2025.06.005","url":null,"abstract":"<div><h3>Background</h3><div>Approximately one in four children who sustain an acquired brain injury (ABI) have attention difficulties impacting education, employment, and community participation. These difficulties arise from dysfunction in attention-related brain networks, incentivizing the use of transcranial direct current stimulation (tDCS). We investigated whether a single tDCS session improved attention following childhood ABI and whether baseline structural connectivity (sc), functional connectivity (fc), attention, and/or simulated electric fields (E-fields) explained variability in response.</div></div><div><h3>Methods</h3><div>In a randomized, single-blind, within-subject, sham-controlled trial, 15 children with ABI (mean 12.7 years) and 15 healthy controls (HCs) received three single tDCS sessions (1 mA dorsolateral prefrontal cortex [dlPFC], 1 mA inferior frontal gyrus [IFG], sham; 20 min) during gamified attention training. We examined postintervention changes in attention according to flanker and stop signal reaction time (RT). We used multimodal analyses (high-density electroencephalography [HD-EEG], diffusion tensor imaging, magnetic resonance imaging) to investigate interindividual variability in tDCS response, according to associations between RT change and baseline fc, sc, attention, and E-fields.</div></div><div><h3>Results</h3><div>Although no effect of active versus sham tDCS was found overall, participants with lower theta or higher gamma default mode network connectivity and poorer attention at baseline showed greater response to tDCS. Higher E-fields were associated with greater response. No serious adverse effects occurred.</div></div><div><h3>Conclusions</h3><div>A single tDCS <strong>s</strong>ession targeting dlPFC or IFG did not improve attention following pediatric ABI. We demonstrated how HD-EEG source-based connectivity may be used to personalize tDCS. Future research should explore whether personalization and/or repeated tDCS sessions can improve attention following pediatric ABI.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 133-145"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsurgical Neurological Emergencies in Children: A Cross-Sectional Study of Prevalence, Diagnosis, and Management","authors":"Kamo Selangaï Doka Hélène MD ,&nbsp;Esene Ignatius MD, MSc, PhD, MPH ,&nbsp;Mercy Berinyuy MD ,&nbsp;Abouame Haoua Palma MD ,&nbsp;Soureya Haman MD ,&nbsp;Sap Suzanne MD","doi":"10.1016/j.pediatrneurol.2025.06.001","DOIUrl":"10.1016/j.pediatrneurol.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to outline the spectrum of pediatric neurological emergencies, assess their prevalence, describe diagnostic approaches, and identify treatment strategies used in their management in a resource-limited country.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study carried out from January 1, 2024, to June 30, 2024, in Garoua General Hospital, Garoua Regional Hospital Center, and Garoua Regional Hospital. Patients’ files were collected from January 1, 2023, to April 30, 2024, hence a study period of 16 months. Analysis was done using Excel 2016, and <em>P</em> values &lt; 0.05 were considered as statistically significant.</div></div><div><h3>Results</h3><div>Of all 3602 children hospitalized in pediatric departments, the prevalence of pediatric neurological emergencies was 6.7%. These emergencies were predominant in children aged between five and 10 years (40.62%) with a median age of 4 years. Males (52.68%) had more emergencies compared with females. Febrile convulsions were the most predominant (63.4%) with the main etiology being meningitis and severe malaria being the differential diagnosis (85.8%). Afebrile convulsions represented 20.1%, with epilepsy as the leading cause, occurring in 11.6% (n = 26). The most observed symptom was convulsions with 81.7% for generalized seizures and 4.5% for partial seizures; this was followed by fever (63.8%), vomiting (44.2%), and headache (29.9%). The majority of hospitalized patients were discharged (81.7%); 12.9% checked out against medical advice, and 5.4% died.</div></div><div><h3>Conclusions</h3><div>Neuropediatric emergencies are frequent and contribute to an increase in infant and child mortality rate. Early diagnosis will lead to early therapy and hence greater chances of survival.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"170 ","pages":"Pages 43-48"},"PeriodicalIF":3.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education and Social Life: The Impact of Headache on Participation in Children and Adolescents Attending a Headache Clinic—A Case-Control Study","authors":"Amalie Akulenok Berring-Uldum MD ,&nbsp;Lene Theil Skovgaard MSc (Cand. Stat., Associate Professor) ,&nbsp;Maria J. Miranda MD, PhD ,&nbsp;Nanette Mol Debes MD, PhD","doi":"10.1016/j.pediatrneurol.2025.05.030","DOIUrl":"10.1016/j.pediatrneurol.2025.05.030","url":null,"abstract":"<div><h3>Background</h3><div>Headaches can have devastating effects on educational and social opportunities. Headache-related absences are linked to poorer school performance, reduced likelihood of attaining higher education, social isolation, and fewer friendships. We assessed the impact of headaches on participation in school and other activities in children and adolescents attending a headache clinic compared to control subjects.</div></div><div><h3>Methods</h3><div>This cross-sectional, case-control study included patients from the Pediatric Headache Outpatient Clinic and control subjects from schools. Participation was measured with Child and Adolescent Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation and Pediatric Migraine Disability Assessment questionnaires. Primary outcomes were missed school, missed other activities, and parents' missed work due to children's headache.</div></div><div><h3>Results</h3><div>Three hundred fifty-four patients and 131 control subjects participated. In the past four weeks, patients had more absences than control subjects, with 1.8 vs 0.3 missed school days, 1.2 vs 0.3 days left early from school, 4.4 vs 0.7 days missed other activities, and 0.8 vs 0.2 lost parental workdays (all <em>P</em> &lt; 0.001). In subgroup analyses, patients with tension-type headache were most severely affected, and compared to patients with migraine had 18.9 vs 3.7 headache days (<em>P</em> &lt; 0.001), 2.3 vs 1.1 missed school days (<em>P</em> = 0.337), 5.6 vs 1.8 days missed other activities (<em>P</em> &lt; 0.001), and 0.4 vs 0.6 parental lost workdays (<em>P</em> = 0.332).</div></div><div><h3>Conclusions</h3><div>Headaches significantly affect participation in children attending a headache clinic compared with control subjects. We recommend routine assessment of participation, identifying patients who would benefit from interventions to reduce absences, subsequently improving education and social life.</div></div>","PeriodicalId":19956,"journal":{"name":"Pediatric neurology","volume":"169 ","pages":"Pages 185-195"},"PeriodicalIF":3.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}