Korean J Pediatr.  2006 May;49(5):533-538. 10.3345/kjp.2006.49.5.533.

A study of neuropeptides related to headaches in children with meningeal irritation signs

• Seo BG
• Yoo MH
• Shim JW
• Shim JY
• Jung HL
• Park MS
• Kim DS

• KMID: 2278571
• DOI: http://doi.org/10.3345/kjp.2006.49.5.533

Abstract

PURPOSE: The headache, one of the symptoms of meningitis, is related to abrupt elevation of intracranial pressure(ICP) or stimulation of intracranial nociceptive structure. However, in cases of mild elevation of ICP or normal findings of cerebrospinal fluid(CSF) analysis, patients sometimes complain of headaches. Therefore, other pathways may contribute to the occurrence of headaches in aseptic meningitis or meningismus. We intend to investigate the role of substance P(SP) and calcitonin gene-related peptide(CGRP) in aseptic meningitis or meningismus.
METHODS
We measured leukocyte count, the concentration of protein and glucose in CSF and ICP of patients with meningeal irritation sign. We also measured SP and CGRP levels by using immunoassay. We analyzed the relationship between the presence of headache and the value of SP and CGRP.
RESULTS
The concentrations of CGRP(18.8+/-10.5 ng/mL) in CSF and ICP(14.8+/-4.5 cmH2O) in aseptic meningitis group were significantly higher than in those(14.1+/-7.4 ng/mL and 12.0+/-5.1 cmH2O, respectively) of the meningismus group(P<0.05). There was no significant difference in the SP levels between the two groups. In the aseptic meningitis group, the concentrations of SP and CGRP were significantly higher in the normal ICP group than in the elevated ICP group(P<0.05).
CONCLUSION
Headaches in children with aseptic meningitis or meningismus is considered to be related to the elevation of the CSF levels of SP and CGRP.

Keyword

Aseptic meningitis; Meningismus; Headache; Substance P; Calcitonin gene-related peptide

MeSH Terms

Calcitonin
Calcitonin Gene-Related Peptide
Child*
Glucose
Headache*
Humans
Immunoassay
Leukocyte Count
Meningism
Meningitis
Meningitis, Aseptic
Neuropeptides*
Substance P
Calcitonin
Calcitonin Gene-Related Peptide
Glucose
Neuropeptides
Substance P