Characteristics of Headache Associated with Intractable Partial Epilepsy

Yankovsky, Alexei; Andermann, Frédérick; Bernasconi, Andrea

doi:10.1111/j.1528-1167.2005.64804.x

Cited by 70 publications

(85 citation statements)

References 25 publications

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“…Surprisingly, one study found that only two of 100 consecutive patients with epilepsy suffered from migraine, and both had classic migraine. The remaining interictal headaches (29 patients) were unclassifiable [12]. Notwithstanding, in our study, 22 patients with interictal headache fulfilled the ICHD-II migraine criteria.…”

Section: Discussionmentioning

confidence: 98%

“…There was a tendency to a higher frequency of seizures in patients with headaches. In the study of Yankovsky et al [12], which only included patients with intractable epilepsy referred for epilepsy surgery, the prevalence of headaches was also high (59%), but nevertheless lower. One study demonstrated a negative effect of comorbid migraine on the prognosis of epilepsy [25].…”

Section: Discussionmentioning

confidence: 99%

“…Many authors have tried to explore this association, but with rather diverse findings. The prevalence of migraine in individuals with epilepsy varies from 2% to 24% [4,6,7,11,12,[16][17][18][19][20]. This large variation is probably due to differences in classifications of both disorders, as well as in the selection of patient populations and diagnostic instruments.…”

Section: Introductionmentioning

confidence: 99%

“…It may occur prior to a seizure (preictal headache), during a seizure (ictal headache), after a seizure (postictal headache) or be unrelated to seizures (interictal headache). Preictal headaches have been reported in 4-15% of patients with epilepsy; ictal headaches are rare, whereas postictal and interictal headaches are common with a frequency of 35%-51% and 31%-64%, respectively [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Headaches add to the burden of epilepsy

et al. 2007

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The objective was to investigate and classify headaches in 109 consecutive adult patients with epilepsy. A semi-structured interview was performed in those who confirmed such symptoms (65%). Interictal headaches were present in 52%; 20% had interictal migraine. Postictal headache was reported in 44%. Migraine characteristics were present in 42% of these, and most of them (74%) also suffered from interictal migraine. Six percent had preictal headache. In partial epilepsy, there was an association between headache lateralisation and interictal EEG abnormalities (p=0.02). We conclude that headache, including migraine, is very common in patients with epilepsy. Unilateral headache may represent a lateralising sign in focal epilepsy. Seizures often trigger postictal headaches with migraine features, which often are associated with interictal migraine. Migrainous headaches sometimes proceed into epileptic seizures. The comorbidity of migraine and epilepsy should receive ample clinical attention, as it may influence antiepileptic drug choice, and the headache may need specific treatment.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Headaches add to the burden of epilepsy

et al. 2007

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“…Psychiatric phenomena in the peri‐ictal period, in particular postictal psychosis, are well described (see, for example, Clancy et al13), and an association with violent acts has been observed. In the general epilepsy population, both postictal confusional states and rage have been documented 14. Such behaviors may reflect alterations in cortical excitability 15.…”

Section: Etiologymentioning

confidence: 99%

Behavioral disorder in people with an intellectual disability and epilepsy: A report of the Intellectual Disability Task Force of the Neuropsychiatric Commission of ILAE

et al. 2016

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SummaryThe management and needs of people with intellectual disability (ID) and epilepsy are well evidenced; less so, the comorbidity of behavioral disorder in this population. “Behavioral disorder” is defined as behaviors that are difficult or disruptive, including stereotypes, difficult or disruptive behavior, aggressive behavior toward other people, behaviors that lead to injury to self or others, and destruction of property. These have an important link to emotional disturbance. This report, produced by the Intellectual Disability Task Force of the Neuropsychiatric Commission of the ILAE, aims to provide a brief review of some key areas of concern regarding behavioral disorder among this population and proposes a range of research and clinical practice recommendations generated by task force members. The areas covered in this report were identified by experts in the field as being of specific relevance to the broad epilepsy community when considering behavioral disorder in persons with epilepsy and ID; they are not intended to be exhaustive. The practice recommendations are based on the authors’ review of the limited research in this field combined with their experience supporting this population. These points are not graded but can be seen as expert opinion guiding future research and clinical practice.

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Headache in epilepsy: A prospective observational study

et al. 2019

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ObjectiveTo assess the frequency and characteristics of interictal and postictal headaches (using International Classification of Headache Disorders, 3rd edition criteria) in a population of patients with epilepsy admitted to the Mayo Clinic Rochester epilepsy monitoring unit and assess their localizing value.MethodsThis was a cross‐sectional study. Participants were voluntarily recruited upon admission to the epilepsy monitoring unit. Two separate questionnaires were then administered. The first was to assess the presence and character of headaches experienced in the past 12 months. The second was to assess characteristics of postictal headaches experienced during their admission including localization.ResultsOne‐hundred and twenty subjects (77%) met inclusion criteria and completed the initial questionnaire. Mean age was 38.1 years (range 18‐82), and 67 (55.8%) were female. Interictal headaches were reported in 97 of 120 (81%) subjects, and these met ICHD3 criteria for migraine in 48 (50%). Postictal headaches were reported by 75 of 120 (63%) subjects on the initial admission questionnaire, representing migraine in 38 (51%). Thirty‐nine (32%) subjects completed the secondary questionnaire related to postictal headaches experienced during admission, of which nine (23%) met criteria for migraine. There was no seizure lateralizing or localizing value noted based on postictal headache localization.SignificanceMigraine was frequent in this cohort and appears to be the dominant interictal and postictal headache type in patients with epilepsy. In this study, the first to assess incident postictal headache in the setting of an ictal EEG, headache localization was of no seizure localizing value. Few patients were being actively treated; suggesting headache management is often overlooked in the epilepsy population.

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Characteristics of Headache Associated with Intractable Partial Epilepsy

Cited by 70 publications

References 25 publications

Headaches add to the burden of epilepsy

Headaches add to the burden of epilepsy

Behavioral disorder in people with an intellectual disability and epilepsy: A report of the Intellectual Disability Task Force of the Neuropsychiatric Commission of ILAE

Headache in epilepsy: A prospective observational study

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