Abstract
Purpose: Headache and epilepsy are common neurological disorders and their relationship is still incompletely known. The purpose of our work was to estimate the most common types of primary headache syndromes and its relation to seizure timing in epileptic patients in Upper Egypt. Patients & Methods: In a cross-sectional study, we evaluated headaches in 100 consecutive patients with idiopathic epilepsy attending the neurology outpatient clinic and the epilepsy clinic at Sohag university hospital by complete medical history, physical and neurologic examination EEG and CT brain. Results: Of our study population, 78% of patients with epilepsy reported headaches. Migraine occurred in 70.6% of patients with headache followed by tension-type headache in 25.58% of patients and other types of headaches occurred in 2.56% of patients. There were 8 patients (10.1%) had a pre-ictal headache, 52 patients (66.5%) had a postictal headache and 39 patients (50%) had an interictal headache. In our study, we found that the occurrence of headache being linked to the female sex, lower mean age, lower mean age at the onset of epilepsy, focal epilepsy, longer duration of epilepsy, high frequency of seizures and the use of polytherapy of antiepileptics. Conclusion: Headache especially migraine is an important comorbidity of epilepsy and should receive more attention especially in female patients, patients with younger age, lower mean age at epilepsy onset, longer duration of the disease, patients on polytherapy, patients with higher frequency of seizures and patients with focal epilepsy.
Highlights
IntroductionIt was reported that the lifetime incidence of epilepsy is ranging from 1 to 26 with a peak age ranges from 30 to 50 years
We found that the occurrence of headache being linked to the female sex, lower mean age, lower mean age at the onset of epilepsy, focal epilepsy, longer duration of epilepsy, high frequency of seizures and the use of polytherapy of antiepileptics
We found that there was no significant association between headache and family history of headache or epilepsy and the same findings were reported by some studies [12] [13] [21]
Summary
It was reported that the lifetime incidence of epilepsy is ranging from 1 to 26 with a peak age ranges from 30 to 50 years. In Upper Egypt, the active prevalence rate ranges from 2.12 to 9.3/1000 with much higher prevalence in infancy and early childhood (62.5 and 37.04/1000, respectively) while the incidence rate ranges from 123 to 150/100,000 [3] [4]. Both epilepsy and headache are very common neurological disorders with episodic attacks. A headache is often underdiagnosed because both physicians and patients are often paying more attention to epilepsy rather than a headache [5] [6] [7]
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