Document Detail

Headache associated with epileptic seizures: epidemiology and clinical characteristics.
MedLine Citation:
PMID:  12482219     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the incidence and characteristics of seizure-associated headaches and the modalities of treatment. BACKGROUND: Systematic investigations of the characteristics of seizure-associated headaches are rare. Although data in the literature on the incidence of postictal headaches range between 37% and 51%, experiences with their treatment are limited and pathophysiological concepts do not exist. METHODS: One hundred ten epileptic outpatients from an epilepsy referral center participated in a semi-standardized interview about headaches associated with epileptic seizures. The characteristics of these patients and of 15 additionally recruited patients with known postictal headaches were analyzed. RESULTS: The incidence of seizure-associated headaches was 43% (n = 47). Forty-three patients had exclusively postictal headaches. One patient had exclusively preictal headaches. Three patients had both pre- and postictal headaches. The duration of postictal headaches was longer than 4 hours in 62.5% of the patients. In the majority of patients, postictal headaches occurred in more than 50% of the seizures. Postictal headaches were treated by self-medication in 19 patients (30%). No patient treated headaches according to a medical prescription. In 11 patients, postictal migraine was untreated. Postictal headaches were associated with focal seizures in 23 patients and/or with generalized seizures in 54 patients. According to the headache classification of the International Headache Society, headaches were classified as migraine-type in 34% of patients and as tension-type headache in 34% of patients. Headaches could not be classified in 21% of patients. Patients with and without postictal headaches did not differ as to localization of the epileptogenic zone or to the number of prescribed antiepileptic drugs. There was no relationship between the localization of the epileptogenic focus, localization of the headache, or the headache classification. CONCLUSIONS: Headaches associated with partial and generalized seizures are frequent and undertreated. Treatment should consider both the headache syndrome and the general guidelines for treating primary headaches. The pathophysiology of seizure-associated headaches cannot be explained by the epileptic syndrome.
Stefanie Förderreuther; Anja Henkel; Soheyl Noachtar; Andreas Straube
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Headache     Volume:  42     ISSN:  0017-8748     ISO Abbreviation:  Headache     Publication Date:    2002 Jul-Aug
Date Detail:
Created Date:  2002-12-16     Completed Date:  2003-02-11     Revised Date:  2009-02-02    
Medline Journal Info:
Nlm Unique ID:  2985091R     Medline TA:  Headache     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-55     Citation Subset:  IM    
Neurologische Klinik und Poliklinik Klinikum Grosshadern, Ludwig-Maximilians University Munich, Germany.
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MeSH Terms
Epilepsy / complications*,  epidemiology
Germany / epidemiology
Headache Disorders / complications*,  drug therapy,  epidemiology
Prospective Studies
Risk Factors

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