Headache in patients with epilepsy: a prospective incidence study

Area of Science:

• Neurology
• Epilepsy Research
• Headache Disorders

Background:

• Previous cross-sectional studies suggest a high prevalence of headache in epilepsy patients based on retrospective recall.
• The relationship between epilepsy and headache requires further prospective investigation, particularly in less refractory epilepsy populations.

Purpose of the Study:

• To prospectively document the incidence of headache in adult patients with less refractory epilepsy over a 3-month period.
• To assess the impact of headache on the quality of life for epilepsy patients.
• To identify the prevalence of different headache types (interictal, periictal) in this cohort.

Main Methods:

• Prospective observational study involving 227 adult patients with less refractory epilepsy (mean seizure frequency 2.46/month).
• Data collection focused on headache episodes, type, treatment, and impact over a 3-month observation period.
• Analysis of headache incidence, including interictal and periictal headache, and self-reported impact.

Main Results:

• Fifty (22%) patients reported at least one headache episode during the 3-month study.
• Specific headache types included interictal (19.8%), periictal (4.8%), and both (2.2%).
• 34% of patients with headache reported a very severe or substantial impact on their lives; 49% used over-the-counter analgesics.

Conclusions:

• Headache incidence in this cohort of epilepsy patients appeared lower than previously reported, suggesting potential underdiagnosis.
• Despite lower incidence, headache significantly impacts the quality of life for epilepsy patients.
• Formal headache diagnoses were absent prior to the survey, indicating a need for better recognition and management of headache in epilepsy care.