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Ictal headache: Insights from two cases.

Arens Taga1,2, Irene Florindo2

  • 11 Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.

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|February 8, 2018
PubMed
Summary

Epileptic headaches mimicking glossopharyngeal neuralgia and short-lasting unilateral neuralgiform headache attacks were described. These cases suggest cortical involvement in paroxysmal headache origins.

Keywords:
Glossopharyngeal neuralgiaSUNCTcortical pain processingepilepsyictal headache

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Area of Science:

  • Neurology
  • Epileptology
  • Headache Medicine

Background:

  • First literature description of ictal epileptic headaches.
  • Mimicking glossopharyngeal neuralgia and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing.

Observation:

  • Case 1: 37-year-old male with pharyngeal, electric-shock headache, speech difficulty, epileptic discharges on EEG, and frontal polymicrogyria.
  • Case 2: 66-year-old male with periocular headache, ptosis, conjunctival injection, lacrimation, facial/limb muscle contractions, and hippocampal abnormalities.

Findings:

  • Epileptic discharges correlated with headache episodes.
  • Brain MRI revealed polymicrogyria and hippocampal abnormalities in the respective cases.

Implications:

  • Highlights the intricate link between epilepsy and headache.
  • Suggests cortical structures contribute to paroxysmal headaches like glossopharyngeal neuralgia and SUNCT/SUNA.