The majority of people with epilepsy experience headaches regardless of gender or age, according to research from Vilnius University, in Lithuania. The study, titled “The burden of headache in people with epilepsy,” was published in the journal Seizure – European Journal of Epilepsy.
Epilepsy is defined as a brain disorder with an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological, and social consequences of the condition. Approximately 50 million people worldwide have epilepsy. It is the most common neurological diseases globally.
Epilepsy and headache often co-exist, with headache attacks being temporally related to the occurrence of epileptic seizures either as pre-ictal, ictal, post-ictal or inter-ictal events (the middle of a seizure is often called the ictal phase). New data suggest that a headache may sometimes be the only ictal manifestation of an epileptic seizure.
“Clinicians should recognize headache as a common comorbidity of epilepsy, as it may influence antiepileptic drug choice, and may need specific treatment,” the authors wrote according to a news release.
In the new study, the team of researchers investigated and classified headaches in adults with epilepsy and evaluated the burden of headaches in that patient group. They also compared findings with a population-based epidemiological study.
A total of 280 people with epilepsy were asked to complete a questionnaire concerning social and demographic factors, health status, presence or non-presence of headaches, and the type of headaches. A neurologist also interviewed study participants.
The results revealed that 83.2% of respondents reported some type of headache. From 77.9% with inter-ictal headaches 39% reported tension-type headache, 31.7% reported migraine, and 7.8% reported medication overuse headache. Possible persistent headache was attributed to traumatic head injury by 16% of the responders.
The impact of headache was assessed using a recognized measure called the Headache-Attributed Lost Time (HALT) grading index. The results showed that 40.4% of the headaches were grade 1 (minimal impact), 9.6% were grade 2, 14.7% were grade 3, and 35.3% were grade 4 (severe impact).
When the researchers compared the results with those from an earlier population-based study they found that the frequencies of most types of headache were similar. The results also showed that migraines seemed to be more common in males with epilepsy than in the general population. Headache attributed to medication overuse was also more common in people with epilepsy than in the general population.
Researchers suggested that headaches in epilepsy may need specific treatment and should receive more clinical attention.