Prevalence and clinical characteristics of headache in juvenile myoclonic epilepsy: experience from a tertiary epilepsy center

Daryan, Metin Dedei; Güveli, Betül Tekin; Baslo, Sezin Alpaydın; Mulhan, Kasım; Sarı, Hüseyin; Balçık, Zeynep Ezgi; Ataklı, Dilek

doi:10.1007/s10072-017-3232-y

Cited by 13 publications

(15 citation statements)

References 30 publications

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“…They highlighted the role of having a family history of migraine as a strong risk factor for migraine comorbidity, similarly 17 . In another cross‐sectional study, the migraine prevalence was found to be 23.5% in patients with JME, whereas it was 16% in the healthy controls 37 …”

Section: Discussionmentioning

confidence: 97%

“…17 In another cross-sectional study, the migraine prevalence was found to be 23.5% in patients with JME, whereas it was 16% in the healthy controls. 37 A plausible explanation for this close relationship between JME and migraine may be through common genetic traits. The coexistence of alterations in the genes encoding ion channel proteins such as CACNA1A, ATP1A2, SCN1A, and PRRT2 in familial hemiplegic migraine and genetic epilepsies have been extensively documented before.…”

Section: F I G U R Ementioning

confidence: 99%

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Headache in idiopathic/genetic epilepsy: Cluster analysis in a large cohort

et al. 2022

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Objective:The link between headache and epilepsy is more prominent in patients with idiopathic/genetic epilepsy (I/GE). We aimed to investigate the prevalence of headache and to cluster patients with regard to their headache and epilepsy features.Methods: Patients aged 6-40 years, with a definite diagnosis of I/GE, were consecutively enrolled. The patients were interviewed using standardized epilepsy and headache questionnaires, and their headache characteristics were investigated by experts in headache. Demographic and clinical variables were analyzed, and patients were clustered according to their epilepsy and headache characteristics using an unsupervised K-means algorithm.Results: Among 809 patients, 508 (62.8%) reported having any type of headache; 87.4% had interictal headache, and 41.2% had migraine. Cluster analysis revealed two distinct groups for both adults and children/adolescents. In adults, subjects having a family history of headache, ≥5 headache attacks, duration of headache ≥ 24 months, headaches lasting ≥1 h, and visual analog scale scores > 5 were grouped in one cluster, and subjects with juvenile myoclonic epilepsy (JME), myoclonic seizures, and generalized tonic-clonic seizures (GTCS) were clustered in this group (Cluster 1). Self-limited epilepsy with centrotemporal spikes and epilepsy with GTCS alone were clustered in Cluster 2 with the opposite characteristics. For children/adolescents, the same features as in adult Cluster 1 were clustered in a separate group, except for the presence of JME syndrome and GTCS alone as a seizure type. Focal seizures were clustered in another group with the opposite characteristics. In the entire group, the model revealed an additional cluster, including patients with the syndrome of GTCS alone (50.51%), with ≥5 attacks, headache lasting >4 h, and throbbing headache; 65.66% of patients had a family history of headache in this third cluster (n = 99).

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Section: Discussionmentioning

confidence: 97%

Section: F I G U R Ementioning

confidence: 99%

Headache in idiopathic/genetic epilepsy: Cluster analysis in a large cohort

et al. 2022

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“…For instance, a review conducted to see the relationship between headache and epilepsy reported the comorbidity of headache and epilepsy as a result of common genetic mutations and clinical features [18,19], but the suggested link is not revealed conclusive evidence of a real causal association [20]. Further, studies also suggested that there are genetic relationships [19] as well as common underlying pathophysiological mechanisms including the imbalance between excitatory and inhibitory neurotransmitters in epilepsy and headache, especially for migraine [18,21]. Proposed theories for shared etiologies include ion channel dysfunction, glutamatergic mechanisms, and mitochondrial dysfunction [22,23].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, estimating the burden of headaches among patients with epilepsy is critically important. Even though a systematic review and meta-analysis has been conducted in 2017 on a similar area of study [27], however, it only assessed the comorbid relationship between migraine and epilepsy [21]. In spite of that, the current review tried to investigate the pooled prevalence of headaches such as migraine, tension-type headaches, and others among patients with epilepsy to summarize the available epidemiologic evidence on the topic and formulate recommendations for future research as well as clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of headaches among patients with epilepsy: a systematic review and meta-analysis

2020

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Background: Headache is the symptom of pain in the face, head or neck that causes disability in most people with medical and neurological disorders. It frequently co-occurs with most chronic diseases such as epilepsy and significantly impacts the quality of life. However, epidemiologic data from different studies showed different rates of prevalence. Therefore, we conducted this review to summarize the available epidemiologic evidence on the topic and formulate recommendations for future research and clinical practice. Methods: We followed the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. We systematically searched the literature using popular databases such as PubMed, EMBASE, Psych-INFO, and SCOPUS. We further scanned the reference lists of the eligible studies to supplement our electronic search. The Comprehensive Meta-Analysis software version 3.0 (CMA 3.0) was used to conduct a meta-analysis. Subgroup and sensitivity analysis were performed and Cochran's Q-and the I 2-test were used to assess the source of heterogeneity. The funnel plot and Egger's regression tests were used to assess potential publication bias. Results: A total of 17 studies conducted both in developed and developing countries including 5564 study participants were combined in this meta-analysis. The pooled estimated prevalence of headache among patients with epilepsy was 48.4%. The pooled estimated prevalence of Inter-Ictal headache (IIH) (42.2%) and Postictal headache (PIH) (43.1%) were higher when compared to tension-type headache (TTH) (26.2%), migraine with aura (26.0%) and migraine without aura (10.4%). The pooled prevalence of headache was 50.6% and 49.5% for developed and developing countries respectively. The pooled prevalence of headache among patients with epilepsy was considerably higher among females (63.0%) when compared to males (33.3%). Moreover, the pooled estimated prevalence of headache among patients with epilepsy was ranging from 46.0% to 52.2% in a leave-one-out sensitivity analysis. Conclusion: The pooled estimated prevalence of headache among patients with epilepsy was considerably high (48.4%). Screening and appropriate management of headaches among patients with epilepsy are warranted.

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“…Juvenile myoclonic epilepsy has both a monogenetic and a complex genetic origin. In one study, 70% of people with this form of epilepsy reported a family history of migraine, almost twice as many as in an age-matched and sex-matched control group, suggesting an overlap in genetic risk between juvenile myoclonic epilepsy and migraine 144 . Some specific genes have also been associated with both epilepsy and migraine 66,145 .…”

Section: [H1] Overlapping Geneticsmentioning

confidence: 99%

Headache in people with epilepsy

et al. 2021

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Epidemiological estimations indicate that individuals with epilepsy are more likely to experience headaches, including migraine than individuals without epilepsy. Headaches can be temporally unrelated to seizures, or can occur before, during or after an episode; seizures and migraine attacks are mostly not temporally linked. The pathophysiological links between headaches (including migraine) and epilepsy are complex and have not yet been fully elucidated. Correct diagnoses and appropriate treatment of headaches in individuals with epilepsy is essential, as headaches can contribute substantially to disease burden. Here, we review the insights that have been made into the associations between headache and epilepsy over the last 5 years, including information on the pathophysiological mechanisms and genetic variants that link the two disorders. We also discuss the current best practice for the management of headaches co-occurring with epilepsy and highlight future challenges for this area of research. [H1] IntroductionThe hallmark of epilepsy is an enduring predisposition to seizures accompanied by neurobiological, cognitive and psychological comorbidities 1 . Epileptic seizures are defined as the disruption of normal neuronal functioning owing to excessive or synchronous neuronal activity, leading to an epileptic event that is discernible by the person and/or by an observer 1 . An analysis for the Global Burden of Disease Study 2016 estimated that >50 million people worldwide had active epilepsy, that is, they had continuing seizures or were receiving epilepsy treatment 2 .The origin and cause of seizures can vary. The International League Against Epilepsy (ILAE) scheme 3 classifies seizures as either "focal", meaning that seizures originate at a specific location in one hemisphere; "generalised", denoting seizures that engage bilaterally distributed networks; or "unknown", for seizures with an undefined origin. The ILAE classifies epilepsy as either "focal", "generalised", "focal and generalised", or "unknown", depending on the type of seizures that occur 3 . The same scheme also classifies epilepsy according to aetiology, including "structural" (for example, associated with a brain tumour or gliosis), "genetic", "metabolic" (for example, associated with mitochondrial disease), "infectious", "immune" or "unknown" 3 . The category "unknown" includes genetic, metabolic and structural causes that have not yet been identified.Headaches are among the commonest disorders globally -the Global burden of Disease Study 2017 estimated that there were > 3 billion individuals with headache across 195 countries and territories 4 . The International Classification of Headache Disorders 3 (ICHD-3) 5 distinguishes between primary headaches -including migraine, tension-type headache (TTH) and trigeminal autonomic cephalalgias -and secondary headaches, which are attributable to other disorders or substances. TTH, which affects >2 billion people globally 4 , is a poorly defined featureless headache that lacks the characteristic featu...

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Prevalence and clinical characteristics of headache in juvenile myoclonic epilepsy: experience from a tertiary epilepsy center

Cited by 13 publications

References 30 publications

Headache in idiopathic/genetic epilepsy: Cluster analysis in a large cohort

Headache in idiopathic/genetic epilepsy: Cluster analysis in a large cohort

The epidemiology of headaches among patients with epilepsy: a systematic review and meta-analysis

Headache in people with epilepsy

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