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Short-lasting retroorbital pain attacks as a form of ictal epileptic headache: Case report

Pedro F Viana1,2, Harumoto Hasegawa3, Josef Jarosz4

  • 11 Department of Clinical Neurophysiology, King's College Hospital, London, UK.

Cephalalgia : an International Journal of Headache
|March 19, 2019
PubMed
Abstract

Insights

Ictal epileptic headache, a rare seizure type, can manifest as severe facial pain. Surgical treatment of frontal lobe epilepsy led to remission of these debilitating headache attacks.

Area of Science:

  • Neurology
  • Epileptology
  • Pain Medicine

Background:

  • Ictal epileptic headache is a rare condition, often presenting as migrainous or tension-type headaches during a seizure.
  • This case highlights a patient experiencing severe retroorbital pain attacks linked to frontal lobe epilepsy.

Observation:

  • A 25-year-old male reported recurrent, short-lasting, excruciating left periorbital and facial pain, predominantly occurring during sleep.
  • Intracranial EEG monitoring and subsequent resection of a right prefrontal focal cortical dysplasia were performed.

Findings:

  • The patient achieved long-term remission of both epileptic seizures and headache attacks following surgical intervention.
  • This outcome suggests the efficacy of resective epilepsy surgery for specific cases of ictal epileptic headache.

Implications:

  • This case expands the understanding of ictal epileptic headache's clinical and neuroanatomical variations.
  • It underscores the prefrontal cortex's role in pain perception and generation.
  • Highlights the importance of considering ictal epileptic headache in patients with unexplained facial pain, especially with comorbid epilepsy or neurological findings.
Keywords:
Ictal epileptic headachecephalic aurafrontal lobe epilepsy

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