Primary headache types in adult epilepsy patients

Abstract

Background Headache is among the most common comorbidities in epilepsy. This study examined the distribution of different primary headache disorders in a large cohort of patients with diagnosed epilepsy. Headache types were analysed with regard to gender, type of epilepsy and antiepileptic drugs (AEDs). Methods In this prospective single-centre study, 500 patients with epilepsy (250 female, mean age: 45.52 ± 17.26 years) were evaluated with regards to primary headache types using a validated German headache questionnaire categorizing for migraine (MIG), tension-type headache (TTH) or trigeminal autonomic cephalalgias (TAC), their combinations and unclassifiable headache. Data regarding type of epilepsy, seizure-associated headache, AED treatment and seizure freedom were collected. Results Of 500 patients with epilepsy, 163 (32.6%) patients (108 female and 55 male) reported suffering from headaches at least 1 day per month. MIG (without aura, with aura) and TTH were the most frequent headache type (MIG 33.1%, TTH 33.1%). Female epilepsy patients reported headaches significantly more often than male patients (x2 = 8.20, p = 0.0042). In contrast, the type of epilepsy did not significantly affect headache distribution. Of 163 patients with headache, 66 (40.5%) patients reported seizure-associated headache and AEDs were used by 157 patients. Of importance, patients with AED monotherapy suffered from MIG less often when compared to patients on polytherapy (x2 = 4.79, p = 0.028). Conclusion MIG and TTH are the most common headache types in epilepsy patients and headache is more frequent among female epilepsy patients. Monotherapy in AEDs might have a beneficial effect on the frequency of headache compared to polytherapy.

Primary Headache Is Related to Reduced Health-Related Quality of Life in Children with Epilepsy

“…TTH was less frequent than MIG, with every fifth child experiencing headaches indicating TTH. Findings in adult patients with epilepsy have showed that MIG and TTH might be the most frequent primary headache types with a similar prevalence of around 33% [29,36]. The lower incidence of TTH in children and a high prevalence of NCH in our study population might suggest that part of the NCH in younger age groups may develop into a more defined primary headache type in adulthood.…”

“…The lower incidence of TTH in children and a high prevalence of NCH in our study population might suggest that part of the NCH in younger age groups may develop into a more defined primary headache type in adulthood. In the whole study population, no child reported the primary headache type TAC or any combination of primary headache types which we previously found in a small subset of our epileptic adult population [36]. Epidemiological data on less common headache types such as TAC are also lacking in the general pediatric population [10].…”

A rare case of lupus cerebritis presenting as ictal epileptic headache: A case report

“…1,2 Up to 65% of individuals with epilepsy experience headaches, with migraine and tension-type headaches being the most common types. [3][4][5] Based on the temporal association with epileptic events, headaches can be categorized as peri-ictal and inter-ictal headaches. 3 Peri-ictal headaches encompass pre-ictal, ictal, and post-ictal headaches, which occur in 5%-15%, 3%-5%, and 10%-50% of patients with epilepsy, respectively.…”

“…Increased neuronal excitability is suggested to be the underlying pathophysiology for both headache and epilepsy 1,2 . Up to 65% of individuals with epilepsy experience headaches, with migraine and tension‐type headaches being the most common types 3–5 . Based on the temporal association with epileptic events, headaches can be categorized as peri‐ictal and inter‐ictal headaches 3 .…”

Studi Literatur: Nyeri Kepala Pada Epilepsi

“…Berdasarkan International Classification of Headache Disorder (ICHD-3) nyeri kepala dibagi menjadi dua yaitu nyeri kepala primer dan nyeri kepala sekunder. Nyeri kepala primer adalah nyeri kepala tanpa adanya penyakit yang mendasarinya terdiri dari migrain, tension type headache (TTH), trigeminal autonomic cephalgia (TAC) dan neuralgia, sedangkan nyeri kepala sekunder adalah nyeri kepala yang disebabkan oleh kelainan lain seperti trauma leher, gangguan vascular, dan lain-lain (Bauer et al, 2021;Schiller et al, 2023). Nyeri kepala dapat ditemukan pada 8-15% populasi dengan epilepsi dan berkaitan dengan durasi, intensitas, dan tipe bangkitan.…”