Ictal epileptic headache as "subtle" symptom in generalized idiopathic epilepsy

Martina Fanella, Jinane Fattouch, Sara Casciato, Leonardo Lapenta, Alessandra Morano, Gabriella Egeo, Mario Manfredi, Massimiliano Prencipe, Anna Teresa Giallonardo, Carlo Di Bonaventura

Research output: Contribution to journalArticlepeer-review


Epilepsy and migraine are common neurologic chronic disorders with episodic manifestations characterized by recurrent attacks and a return to baseline conditions between attacks. Epilepsy and migraine are frequently observed in comorbidity, with the occurrence of one disorder increasing the probability of the other: Migraine occurs in about one-fourth of patients with epilepsy, whereas epilepsy is present in 8-15% of patients with migraine. The link between headache and seizures is controversial and multifactorial. In epilepsy, headache can be seen as a preictal, ictal, or postictal phenomenon. In this report, we describe a case of a 37-year-old patient, affected by both drug-resistant generalized idiopathic epilepsy and headache, who displayed the sudden onset of a headache attack referred during a 24-h electroencephalography (EEG). The EEG tracing during this event revealed the activation of subcontinuous epileptic activity consisting of generalized spike-wave discharges (GSWDs) and generalized polyspike and wave discharges (GPSWDs) that persisted for 60 min, that is, until the disappearance of the headache. The case we describe appears to be original in that it represents one of the few EEG-documented ictal epileptic headaches in generalized idiopathic epilepsy.

Original languageEnglish
Issue number4
Publication statusPublished - Apr 2012


  • Comorbidity
  • EEG
  • Ictal epileptic headache
  • Idiopathic generalized epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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