High prevalence of headaches in patients with epilepsy
TL;DR: The high prevalence of postictal headaches confirms the frequent triggering of a headache by a seizure, a condition in which the real triggering effect of the headache on the seizure might be difficult to prove.
Abstract: To examine the association between headaches and epilepsy. Consecutive adult epileptic patients who went to the outpatient clinic of the Epilepsy Center of PLA General Hospital between February 01, 2012, and May 10, 2013, were recruited into this study. A total of 1109 patients with epilepsy completed a questionnaire regarding headaches. Overall, 60.1% of the patients (male: 57.2%; female: 63.8%) reported headaches within the last year. The age-weighted prevalence of interictal migraine was 11.7% (male 8.9%, female 15.3%), which is higher than that reported in a large population-based study (8.5%, male 5.4%, female 11.6%) using the same screening questions. The prevalence of postictal headaches was 34.1% (males 32.7%, females 35.2%), and the presence of preictal headaches was 4.5% (males 4.3%, females 5.2%). The prevalence of headache yesterday in the general population was 4.8% (male 3.0%, female 6.6%). Thus, the prevalence of headaches, including migraine, is higher in epileptic patients in China. The high prevalence of postictal headaches confirms the frequent triggering of a headache by a seizure. A much lower frequency of preictal headaches, a condition in which the real triggering effect of the headache on the seizure might be difficult to prove.
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TL;DR: In this article , the authors evaluated the prevalence of various forms of headache in patients living with epilepsy (PWE) and found that the most common type of headache was interictal in 80% of PWE patients.
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TL;DR: In this article , a graph theory-based approach was employed to characterize the topological properties of the structural network in patients with temporal lobe epilepsy and comorbid headache, which revealed abnormal structural connections between the temporoparietal lobe, occipital lobe, insula, cingulate gyrus, and thalamus.
TL;DR: Control of seizures in epileptic patients help in controlling headaches and decrease its frequency, found that the occurrence of headaches being linked to longer duration of epilepsy, high frequency of seizures and use of polytherapy of antiepileptics.
Abstract: Background: Epilepsy and headache are the two most common neurologic disorders affecting individuals of all ages worldwide. The relation between headache and epilepsy is complicated, and the comorbidity of headache and epilepsy is still poorly understood. Aim of the work: Study of headache characteristics in controlled and uncontrolled epileptic patients. Methods: We evaluated headaches in 100 consecutive patients with epilepsy attending the outpatient clinic and epilepsy clinic at Sohag university hospital and performed interictal EEG to all patients. Results: In our study we found that the occurrence of headaches being linked to longer duration of epilepsy, high frequency of seizures and use of polytherapy of antiepileptics. Conclusion: Control of seizures in epileptic patients help in controlling headaches and decrease its frequency.
TL;DR: In this article , the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.
Abstract: Background Migraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert. Methods In this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis. Results Longer headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone. Conclusion Longer headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs.
26 Oct 2020
TL;DR: In children with epilepsy, headache was associated with higher rate of generalized epileptiform activity, increased frequency of seizures and use of monotherapy, and migraine is the commonest type in epileptic group and tension type headache in the control group.
Abstract: Background: Epilepsy is a common pediatric health problem that urges parents to seek medical advice. However, it could be associated with prodromal manifestation [e.g., headache] that the parents usually pass unnoticed. Previous literature is defective regarding the prevalence of headaches among children with epilepsy. Aim of the work: Estimating the prevalence and characteristics of headaches associated with epilepsy in pediatric populations. Patients and methods: We included 130 children with epilepsy [study group] and 130 healthy children as a control group. All were selected from Al-Azhar University Hospitals [new Damietta]. An inquiry about headache and its characteristics, especially in relation to seizure attacks, had been performed. Results: Children with epilepsy had a higher rate of headache when compared to healthy children [48.5% versus 22.3%];migraine is the commonest type in the epileptic group and tension-type headache in the control group. In children with epilepsy, headaches were associated with a higher rate of generalized epileptiform activity, increased frequency of seizures, and monotherapy use. Conclusion: Headache is highly prevalent among children with epilepsy and necessitates proper screening, further investigations, and proper treatment. Future studies to investigate the problem on a wide scale are warranted.
Cites background from "High prevalence of headaches in pat..."
...In adult populations with epilepsy, Wang et al.[15] reported a prevalence of 12....
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...In adult populations with epilepsy, Wang et al.[15] reported a prevalence of 12.5% of headache among a large sample size consisted of 1109 patients....
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...However, others reported increased headaches in younger females[15]....
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5,847 citations
TL;DR: The calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine, which would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women.
Abstract: This study, which is a part of the initiative 'Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide', assesses and presents all existing evidence of the world prevalence and burden of headache disorders. Population-based studies applying International Headache Society criteria for migraine and tension-type headache, and also studies on headache in general and 'chronic daily headache', have been included. Globally, the percentages of the adult population with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Our calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine. On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women.
2,067 citations
"High prevalence of headaches in pat..." refers background in this paper
...Primary headache disorders, particularly migraine and tension-type headache (TTH), are globally prevalent [1-5]....
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1,674 citations
TL;DR: The magnitude and distribution of the public health problem posed by migraine in the United States is described by examining migraine prevalence, attack frequency, and attack-related disability by gender, age, race, household income, geographic region, and urban vs rural residence.
Abstract: Objective. —To describe the magnitude and distribution of the public health problem posed by migraine in the United States by examining migraine prevalence, attack frequency, and attack-related disability by gender, age, race, household income, geographic region, and urban vs rural residence. Design. —In 1989, a self-administered questionnaire was sent to a sample of 15000 households. A designated member of each household initially responded to the questionnaire. Each household member with severe headache was asked to respond to detailed questions about symptoms, frequency, and severity of headaches. Setting. —A sample of households selected from a panel to be representative of the US population in terms of age, gender, household size, and geographic area. Participants. —After a single mailing, 20468 subjects (63.4% response rate) between 12 and 80 years of age responded to the survey. Respondents and non-respondents did not differ by gender, household income, region of the country, or urban vs rural status. Whites and the elderly were more likely to respond. Migraine headache cases were identified on the basis of reported symptoms using established diagnostic criteria. Results. —17.6% of females and 5.7% of males were found to have one or more migraine headaches per year. The prevalence of migraine varied considerably by age and was highest in both men and women between the ages of 35 to 45 years. Migraine prevalence was strongly associated with household income; prevalence in the lowest income group ( Conclusions. —A projection to the US population suggests that 8.7 million females and 2.6 million males suffer from migraine headache with moderate to severe disability. Of these, 3.4 million females and 1.1 million males experience one or more attacks per month. Females between ages 30 to 49 years from lower-income households are at especially high risk of having migraines and are more likely than other groups to use emergency care services for their acute condition. (JAMA. 1992;267:64-69)
1,576 citations
"High prevalence of headaches in pat..." refers background in this paper
...Primary headache disorders, particularly migraine and tension-type headache (TTH), are globally prevalent [1-5]....
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TL;DR: The study supports the notion that migraine and tension-type headache are separate clinical entities and that migraine without aura and migraine with aura are distinct subforms of migraine.
Abstract: Headache disorders constitute a public-health problem of enormous proportions, with an impact on both the individual sufferer and society. Epidemiological knowledge is required to quantitate the significance of these disorders. The effects on individuals can be assessed by examining prevalence, distribution, attack frequency and duration, and headache-related disability. The socio-economic burden includes both direct costs associated with health care utilization and costs associated with missed work due to sickness absence or reduced efficiency. The individual and socio-economic burden of headaches is substantial. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.
695 citations