Peri-ictal headaches in the paediatric population - prospective study
Marta Zawadzka1, Ewa Pilarska1, Seweryna Konieczna1
1Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland.
Insights
Headache and epilepsy in children are linked, with most headaches occurring after seizures (post-ictal). These headaches are often moderate and more common after generalized seizures.
Area of Science:
- Pediatric Neurology
- Epileptology
- Headache Medicine
Background:
- Headache and epilepsy frequently co-occur in adults.
- Understanding this relationship in children is crucial for effective management.
- Peri-ictal headaches present a significant challenge in pediatric epilepsy care.
Purpose of the Study:
- To investigate correlations between peri-ictal headache types and seizure types in children.
- To identify characteristic trends in pediatric peri-ictal headaches.
- To analyze the timing and intensity of headaches related to seizures in pediatric patients.
Main Methods:
- Prospective study involving 57 children with peri-ictal headaches.
- Guardians maintained a 180-day diary for seizure and headache episodes.
- Systematic history taking during follow-up visits documented headache characteristics.
Main Results:
- 913 seizures and 325 peri-ictal headaches were recorded.
- Post-ictal headaches were most frequent, occurring within 1 hour after seizures.
- Headaches were typically moderate in intensity, with only 30% of patients using analgesics.
Conclusions:
- Peri-ictal headaches are a notable issue for children with epilepsy.
- Post-ictal headaches, often following generalized seizures, are the most common type.
- Further research can guide targeted treatment strategies for pediatric epilepsy-associated headaches.
Introduction:
The co-occurrence of headache and epilepsy is well-documented in the adult population. The aim of the prospective study was to analyse in the paediatric population the correlations between the types of peri-ictal headaches and types of seizures. Furthermore, an attempt was made to find trends in characteristic features of peri-ictal headaches.Material: A total of 57 children with peri-ictal headache were enrolled in the study. The participants' guardians were asked to keep a diary of the seizure and peri-ictal headache episodes during a 180-day period. During follow-up visits, systematic history regarding peri-ictal headaches was taken.
Results:
A total of 913 seizure and 325 peri-ictal headache episodes were noted during the study. Post-ictal headaches were most common, occurring in < 1 h after the seizure, lasting minutes to hours and more likely to occur after generalised seizures, whereas pre-ictal headaches occurred 30-240 min before the seizure. In the analysed group, peri-ictal headaches were most often moderate in intensity. Only 30% of patients took analgesic medication, usually to treat post-ictal headaches.
Conclusion:
Peri-ictal headaches are a significant health problem for patients with epilepsy. The most common type are post-ictal headaches, and they are most likely to appear after a generalised seizure.
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