What have we learned about ictal epileptic headache? A review of well-documented cases

Pasquale Parisi, Pasquale Striano, Alberto Verrotti, Maria Pia Villa, Vincenzo Belcastro

Research output: Contribution to journalArticlepeer-review


Purpose: The case report published in this issue by Wang et al. offers us an opportunity to review previously published "ictal epileptic headache" cases and draw attention to the criteria that have recently been published for this condition, taking into consideration not only the clinical-EEG and physiopathogenetic investigations required to diagnose this condition, but also the therapeutic aspects of the issue. Methods: To this aim we reviewed all well-documented cases that have been reported in the literature. Results: The relationship between headache and seizures is somewhat complicated. Although the nature of this association is not yet fully clear, several plausible explanations have been proposed. Further experimental and clinical investigations are, however, warranted to gain a better understanding of this relationship. Epilepsy and idiopathic headache/migraine share several pathophysiological mechanisms; a better understanding of these mechanisms will allow us to more accurately to assess the "real burden" and prevalence of the "ictal epileptic headache" phenomenon and its therapeutic implications. Conclusions: The development of animal models and molecular studies and, above all, multicenter clinical studies conducted according to the proposed IEH criteria represent the starting point for a definitive international consensus on this intriguing topic. In addition, to improve the recognition of ictal epileptic headache, we should encourage the use of EEG recording in the emergency setting.

Original languageEnglish
Pages (from-to)253-258
Number of pages6
Issue number4
Publication statusPublished - May 2013


  • Autonomic seizures
  • Clinical-EEG criteria
  • Epidemiology
  • Epilepsy
  • Headache
  • Headache and epilepsy comorbidity
  • Ictal epileptic headache
  • Ictal epileptic semiology
  • Migraine
  • New classification criteria

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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