New-onset interictal headache in Persons with epilepsy (PWE): A case-control study
Jashobanta Sahu1, Pradeep Pankajakshan Nair1, Vaibhav Wadwekar1
1Department of Neurology, JIPMER, Pondicherry, India.
Epilepsy & Behavior : E&B
|October 6, 2018
Summary
Headache is common in people with epilepsy (PWE) taking antiepileptic drugs (AEDs). This study found that carbamazepine (CBZ) was not more likely to cause headaches than other AEDs, and fewer seizures/EEG abnormalities predicted headache.
Area of Science:
- Neurology
- Epilepsy Research
- Headache Medicine
Background:
- Headache is a frequent complaint among persons with epilepsy (PWE) using antiepileptic drugs (AEDs).
- Carbamazepine (CBZ) is a commonly prescribed AED, and anecdotal evidence suggests it may be associated with headaches.
- There is a lack of systematic studies investigating the relationship between AEDs and headache in PWE.
Purpose of the Study:
- To assess the association of new-onset interictal headache in PWE with CBZ compared to other AEDs.
- To identify factors associated with AED-induced headaches in PWE.
Main Methods:
- Screened 2000 PWE on AEDs to identify 165 with new-onset interictal headache.
- Recruited 157 PWE with headache and 157 age- and sex-matched PWE without headache as controls.
- Utilized a headache questionnaire based on International Classification of Headache Disorders (ICHD-II) criteria and collected data on demographics, seizure characteristics, AEDs, EEG, and neuroimaging.
Main Results:
- Among PWE with headache, 56.1% were on CBZ, but this was not significantly different from controls.
- 45% of headaches were migrainous in character.
- Lower seizure frequency and fewer EEG abnormalities were independent predictors of headache in both univariate and multivariate analyses.
Conclusions:
- New-onset interictal headache is a significant issue in PWE, with non-migrainous headaches being more common.
- CBZ did not show a predilection for causing new-onset interictal headaches compared to other AEDs.
- Reduced seizure frequency and EEG abnormalities suggest AEDs may be significant contributing factors to headache development in PWE.
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