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Epilepsy and Seizures: Overview01:24

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The complex interrelations between two paroxysmal disorders: headache and epilepsy.

Carlo Cianchetti1, Giuliano Avanzini2, Filippo Dainese3

  • 1Former Professor of Child and Adolescent Neurology and Psychiatry, University of Cagliari, Cagliari, Italy. cianchet@unica.it.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|March 26, 2017
PubMed
Summary
This summary is machine-generated.

This review systematizes the complex relationship between headache and epileptic seizures. It differentiates headache types occurring before, during, and after seizures, crucial for accurate diagnosis and treatment.

Keywords:
EpilepsyEpileptic headacheHeadacheHemicrania epilepticaIctal epileptic headacheMigraineMigralepsy

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Area of Science:

  • Neurology
  • Epileptology
  • Headache Medicine

Background:

  • The relationship between headache and epileptic seizures is complex and lacks clear systematization.
  • Distinguishing between migraine and epileptic headache is clinically challenging.
  • Existing terminology, such as "migralepsy," requires clarification.

Purpose of the Study:

  • To provide a systematic organization of the interrelations between headache and epileptic seizures.
  • To clarify diagnostic criteria for various headache types associated with epilepsy.
  • To propose a classification for headache and seizure phenomena.

Main Methods:

  • Systematic review and organization of existing literature.
  • Classification of headaches based on timing relative to epileptic seizures (pre-ictal, ictal, post-ictal, inter-ictal).
  • Differentiation of headache types, specifically migraine-type versus non-migraine-type headaches.

Main Results:

  • Established clear distinctions between pre-ictal, ictal, and post-ictal headaches in relation to epileptic seizures.
  • Defined "epileptic headache" (ictal epileptic headache) as a distinct entity requiring EEG confirmation.
  • Highlighted the need to differentiate epileptic headache from other headache types and ictal non-epileptic headaches.
  • Identified post-ictal headaches as a common occurrence following seizures, especially in patients with co-existing migraine.

Conclusions:

  • A systematic approach is necessary to understand the headache-epilepsy connection.
  • Precise terminology and diagnostic criteria are essential for accurate clinical management.
  • The proposed classification aids in differentiating and managing headache disorders in epileptic patients.