Treatment of postictal headache: a systematic review and future directions

Shahisavandi, Mina; Zeraatpisheh, Zahra; Rostaminejad, Marzieh; Asadi‐Pooya, Ali A.

doi:10.1016/j.yebeh.2021.107971

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…In human clinical studies, it is stated that despite the frequent postictal complaints of patients, e.g., headaches, a common clinical practice by physicians is focusing only on the treatment of seizures. Consequently, the management of postictal signs, which can significantly impact a patient’s QoL, is frequently overlooked or given less attention [ 30 ]. This could be due to the fact that despite the important role of the postictal phase in the QoL, there are no evidence-based treatment protocols in human or veterinary medicine, and the evidence focusing on the postictal phase semiology and management is scarce [ 8 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

The Postictal Phase in Canine Idiopathic Epilepsy: Semiology, Management, and Impact on the Quality of Life from the Owners’ Perspective

Kähn,

Meyerhoff,

Meller

et al. 2023

Animals

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Background: Dogs with idiopathic epilepsy experience not only the preictal and ictal seizure phases but also the postictal phase. To date, research has primarily focused on the preictal and ictal semiology and therapeutic control of ictal events. Research into the postictal phase‘s pathophysiology, as a therapeutic target and how it impacts the quality of life, is sparse across different species. Interestingly, even if anecdotally, owners report the postictal period being an impactful negative factor on their quality of life as well as their dog’s quality of life. Hypothesis/objectives: We aimed to assess the semiology and the impact of postictal signs on the quality of life of owners and dogs. Method: This observational study was carried out using surveys of owners of dogs with seizure disorders. Results: The questionnaire was filled out by 432 dog owners, 292 of whom provided complete responses that could be analysed. More than nine out of ten owners (97%) reported the presence of various postictal clinical signs. The dog’s and the owner’s quality of life was mainly affected by specific postictal signs, i.e., disorientation (dog: 31%; owner: 20%), compulsive walking (dog: 17%; owner: 22%), ataxia (dog: 12%; owner: 6%), and blindness (dog: 17%; owner: 10%). Nearly 61% of the owners felt that the severity of postictal signs was moderate or severe. Rescue antiseizure medications did not have an effect on controlling the postictal signs based on 71% of the responders. In contrast, 77% of the respondents reported that other measures such as rest, physical closeness, and a quiet and dark environment had a positive impact on the postictal phase. Conclusions and clinical importance: Overall, this survey shows that specific postictal signs are common and have a notable impact on the perceived quality of life of both dogs and their owners. According to the respondents, antiseizure medication might have no influence on the postictal phase in most cases, in contrast to other nonpharmacological measures. Further research on the management of the postictal phase is vital for improving the quality of life of dogs with seizure disorders and their owners.

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Section: Discussionmentioning

confidence: 99%