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Preictal headache in partial epilepsy.

A E Yankovsky1, F Andermann, S Mercho

  • 1Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada.

Neurology
|December 29, 2005
PubMed
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Preictal headache (PIHA) in epilepsy patients often presents on the same side as the seizure focus, particularly in temporal lobe epilepsy. Surgical relief from seizures also frequently eliminates PIHA, suggesting its value as a lateralizing sign.

Area of Science:

  • Neurology
  • Epileptology
  • Headache Medicine

Background:

  • Intractable focal epilepsy presents diagnostic challenges.
  • Preictal headache (PIHA) is a potential symptom preceding epileptic seizures.
  • Understanding PIHA's characteristics may aid in epilepsy localization.

Purpose of the Study:

  • To investigate the clinical characteristics of preictal headache in patients with intractable focal epilepsy.
  • To evaluate the relationship between PIHA laterality and the epileptic focus.
  • To assess the impact of epilepsy surgery on PIHA.

Main Methods:

  • Standardized interviews were conducted with 11 patients experiencing intractable focal epilepsy and PIHA.
  • Headache location (ipsilateral/contralateral to focus) and migrainous features were recorded.

Related Experiment Videos

  • Outcomes regarding PIHA were assessed post-epilepsy surgery.

    • Main Results:

    • Nine of 11 patients with temporal lobe epilepsy (TLE) reported frontotemporal, ipsilateral PIHA.
    • One TLE patient and one with frontal seizures experienced contralateral PIHA.
    • Four patients exhibited migrainous features.
    • Seven seizure-free patients and two with reduced seizures post-surgery were also free of PIHA.

    Conclusions:

    • Preictal headache in TLE is often ipsilateral to the seizure focus.
    • PIHA may serve as a valuable lateralizing sign in temporal lobe epilepsy.
    • Successful epilepsy surgery can lead to the resolution of PIHA.