Skip to main content

Advertisement

Log in

Peri-ictal and inter-ictal headache in children and adolescents with idiopathic epilepsy: a multicenter cross-sectional study

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Purpose

Headache in epileptic population ranges from 8% to 15%. The aim of this paper was to study the clinical and temporal characteristics of primary headache comorbidity in idiopathic epileptic children.

Methods

From June 2006 to June 2009, a cross-sectional multi-center study involving five Italian Child Neurology University Centers (two in Rome, one in Chieti, one in Naples, and one in L'Aquila) was conducted. Among 1,264 consecutively newly diagnosed, idiopathic, partial, or generalized, epileptic children, according to ILAE diagnostic criteria (aged between 5 and 15 years of age), we selected 142 children (11.2%) (130 of whom completed the study) who showed an associated peri-ictal and/or inter-ictal headache diagnosed according to the International Headache Society Criteria. Rare cases of “ictal epileptic headache”, in which headache represents the sole ictal epileptic manifestation, were excluded from this study.

Results and conclusions

Post-ictal headaches were most frequent (62%). Pre-ictal headaches were less common (30%). Inter-ictal headaches were described in 57.6%. Clear migrainous features were present in 93% of pre-ictal and 81.4% of post-ictal headaches. Inter-ictal headaches meet criteria for migraines in 87%. The association between partial epilepsy and migraine without aura is most common and reported in 82% of our patients with peri-ictal headache and in 76.5% of patients with post-ictal headache.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Andermann E, Andermann F (1987) Migraine–epilepsy relationships: epidemiological and genetic aspects. In: Andermann FA, Lugaresi E (eds) Migraine and epilepsy. Butterworths, Boston, pp 281–291

    Google Scholar 

  2. Schon F, Blau JN (1987) Post-epileptic headache and migraine. J Neurol Neurosurg Psychiatry 50:1148–1152

    Article  PubMed  CAS  Google Scholar 

  3. Ito M, Schachter SC (1996) Frequency and characteristics of interictal headaches in patients with epilepsy. J Epilepsy 9:83–86

    Article  Google Scholar 

  4. Leniger T, Isbruch K, Driesch S, Diener HC, Hufnagel A (2001) Seizure-associated headache in epilepsy. Epilepsia 42:1176–1179

    Article  PubMed  CAS  Google Scholar 

  5. Ito M, Adachi N, Nakamura F, Koyama T, Okamura T, Kato M et al (2003) Multi-center study on post-ictal headache in patients with localization-related epilepsy. Psychiatry Clin Neurosci 57:385–389

    Article  PubMed  Google Scholar 

  6. Parisi P (2009) Why is migraine rarely, and not usually, the sole ictal epileptic manifestation? Seizure 18(5):309–312

    Article  PubMed  Google Scholar 

  7. Parisi P, Kasteleijn-Nolst Trenite DGA (2010) “Migralepsy”: a call for revision of the definition. Epilepsia 51(5):932–933

    Article  PubMed  Google Scholar 

  8. Parisi P (2009) Who's still afraid of the link between headache and epilepsy? Some reactions to and reflections on the article by Marte Helene Bjørk and co-workers. J Headache Pain 10(5):327–329

    Article  PubMed  Google Scholar 

  9. HELP (Headache in Epileptic Patients) Study Group (2010) Multi-center study on migraine and seizures-related headache in patients with epilepsy. Yonsei Med J 51:219–224

    Article  Google Scholar 

  10. Karaali-Savrun F, Goksan B, Yeni SN et al (2002) Seizure related headache in patients with epilepsy. Seizure 11:67–69

    Article  PubMed  Google Scholar 

  11. Forderreuther S, Henkel A, Noachtar S et al (2002) Headache associated with epileptic seizures: epidemiology and clinical characteristics. Headache 42:649–655

    Article  PubMed  Google Scholar 

  12. Bernasconi A, Andermann F, Bernasconi N et al (2001) Lateralizing value of peri-ictal headache: a study of 100 patients with partial epilepsy. Neurology 56:130–132

    PubMed  CAS  Google Scholar 

  13. Schachter SC, Richman K, Loder E, Belk S (1995) Self-reported characteristics of postictal headaches. J Epilepsy 8:41–43

    Article  Google Scholar 

  14. D'Alessandro R, Sacquegna T, Pazzaglia P et al (1987) Headache after partial complex seizures. In: Andermann F, Lugaresi E (eds) Migraine and epilepsy. Butterworth, Boston, MA, pp 273–278

    Google Scholar 

  15. Ito M, Nakamura H, Honma H, Takeda Y, Kobayashi R, Miyamoto T et al (1999) A comparison of post-ictal headache between patients with occipital lobe epilepsy and temporal lobe epilepsy. Seizure 8:343–346

    Article  PubMed  CAS  Google Scholar 

  16. Ito M, Nakamura H, Honma H, Takeda Y, Kobayashi R, Miyamoto T et al (2000) Clinical factors associated with postictal headache in patients with epilepsy. Acta Neurol Scand 102:129–131

    Article  PubMed  CAS  Google Scholar 

  17. Ito M, Adachi N, Nakamura F, Koyama T, Okamura T, Kato M et al (2004) Characteristics of postictal headache in patients with partial epilepsy. Cephalalgia 24:23–28

    Article  PubMed  CAS  Google Scholar 

  18. Yankovsky AE, Andermann F, Bernasconi A (2005) Characteristics of headache associated with intractable partial epilepsy. Epilepsia 46:1241–1245

    Article  PubMed  Google Scholar 

  19. Berg AT, Berkovic SF, Brodie MJ et al (2010) Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia 51:676–685

    Article  PubMed  Google Scholar 

  20. Yankovsky AE, Andermann F, Mercho S, Dubeau F, Bernasconi A (2005) Preictal headache in partial epilepsy. Neurology 65:1979–1981

    Article  PubMed  CAS  Google Scholar 

  21. International Headache Society (2004) The international classification of headache disorders: 2nd edition. Cephalalgia 24(suppl 1):9–160

    Google Scholar 

  22. Toldo I, Perissinotto E, Menegazzo F et al (2010) Comorbidity between headache and epilepsy in a pediatric headache center. J Headache Pain 11:235–240

    Article  PubMed  Google Scholar 

  23. Ito M, Adachi N, Nakamura F et al (2002) Seizure-related headache in patients with epilepsy. Seizure 11:67–69

    Article  Google Scholar 

  24. Kasteleijn-Nolst Trenité DGA, Verrotti A, Di Fonzo A, Cantonetti L, Bruschi R, Chiarelli F, Villa MP, Parisi P (2010) Headache, epilepsy and photosensitivity: how are they connected? J Headache Pain 11:469–476

    Article  PubMed  Google Scholar 

  25. Papetti L, Spalice A, Nicita F, Paolino MC, Castaldo R, Iannetti P, Villa MP, Parisi P (2010) Migraine treatment in developmental age: guidelines update. J Headache Pain 11(3):267–276

    Article  PubMed  Google Scholar 

  26. Cai S, Hamiwka LD, Wirrell EC (2008) Peri-ictal headache in children: prevalence and character. Pediatr Neurol 39:91–96

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

We have no conflict of interest in publishing this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pasquale Parisi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verrotti, A., Coppola, G., Spalice, A. et al. Peri-ictal and inter-ictal headache in children and adolescents with idiopathic epilepsy: a multicenter cross-sectional study. Childs Nerv Syst 27, 1419–1423 (2011). https://doi.org/10.1007/s00381-011-1428-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-011-1428-7

Keywords

Navigation