The complex interrelations between two paroxysmal disorders: headache and epilepsy

Carlo Cianchetti, Giuliano Avanzini, Filippo Dainese, Vincenzo Guidetti

Research output: Contribution to journalReview article

Abstract

The interrelations between headache/migraine and epileptic seizures are an interesting topic, still lacking a systematization, which is the objective of the present revision. We organize the general setting on: (a) a distinction between pre-ictal, ictal, post-ictal and inter-ictal headaches, assuming “ictal” as epileptic seizure, and (b) the kind of headache, if it is of migraine type or not. Concerning pre-ictal migraine/headache, the necessity of its differentiation from an epileptic headache presenting as an aura of a seizure is stressed; this is connected with the indefiniteness of the term “migralepsy”. The term “migraine aura-triggered seizure” should be used only in front of a proven triggering effect of migraine. Epileptic headache (called also “ictal epileptic headache”) is a well-characterized entity, in which different types of head pain may occur and an ictal EEG is necessary for the diagnosis. It may present as an isolated event (“isolated epileptic headache”), requiring a differential diagnosis from other kinds of headache, or it may be uninterruptedly followed by other epileptic manifestations being in this case easily identifiable as an epileptic aura. Hemicrania epileptica is a very rare variant of epileptic headache, characterized by the ipsilaterality of head pain and EEG paroxysms. Ictal non-epileptic headache needs to be differentiated from epileptic headache. Post-ictal headaches are a frequent association of headache with seizures, particularly in patients suffering also from inter-ictal headache-migraine. The reported systematization of the topic led us to suggest a classification which is shown in Appendix.

Original languageEnglish
Pages (from-to)941-948
Number of pages8
JournalNeurological Sciences
Volume38
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

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Keywords

  • Epilepsy
  • Epileptic headache
  • Headache
  • Hemicrania epileptica
  • Ictal epileptic headache
  • Migraine
  • Migralepsy

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health

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