All issues > Volume 49(5); 2006

Original Article

Korean J Pediatr. 2006;49(5):533-538. Published online May 15, 2006.

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

Bo Gil BG Seo¹, Myung Hwan MH Yoo¹, Jae Won JW Shim¹, Jung Yeon JY Shim¹, Hye Lim HL Jung¹, Moon Soo MS Park¹, Deok-Soo DS Kim¹

¹Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seou

Correspondence Deok-Soo DS Kim ,Email: dskim@skku.edu

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¡¾10.5 ng/mL) in CSF and ICP(14.8¡¾4.5 cmH2O) in aseptic meningitis group were significantly higher than in those(14.1¡¾7.4 ng/mL and 12.0¡¾5.1 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.

Keywords :Aseptic meningitis , Meningismus , Headache , Substance P , Calcitonin gene-related peptide