[Paroxysmal epileptic headache]

Epileptic paroxystic headache consists of an episode of pain that starts suddenly, in a varying area that is usually the same for the same patient, of medium to high intensity, lasting from a few seconds to minutes and, rarely, hours; the episode subsides spontaneously and tends to recur. This was found in 32 of 125 patients studied by the author. Average age of onset was 11 years, with 80% of cases presenting it in the first or second decade of life. Once diagnosed, the condition was present a maximum of 41 years and a minimum of one month, with an average of six years. Headache lasted from 30 seconds to 4 hours; in 62% of cases it was 15 minutes or less. Pain was severe in 24 patients and moderate in 8. Epileptic paroxystic headache can be the only epileptic symptom (31%) or be associated with other ictal manifestations, independently (56.2%) or simultaneously (12.5%). EEG studies showed focalization in temporal lobe (56%), in the midbrain (12.5%) or in other areas. Treatment with hydantoine, primidone and methylsuccimide gave excellent results. Differential diagnosis with other paroxystic headaches is noted.