High prevalence of headaches in patients with epilepsy

Abstract

Background: To examine the association between headaches and epilepsy.

Methods: 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.

Results: 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.

Conclusions: 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.

Figure 1

Prevalence of headache in patients with epilepsy compared to population-based door-to-door survey of headache in China.

Figure 2

Diagram of types of interitcal headache in patients with epilepsy (n = 231).

Figure 3

Prevalence of interictal migraine in patients with epilepsy compared to a population-based door-to-door survey of headache in China.

Figure 4

Prevalence of headache on seizure-day in epileptic patients and headache yesterday a population-based door-to-door survey of headache in China.

Figure 5

Regional distribution of epileptic patients in the current study (n = 1109) and people in a population-based door-to-door survey of headache in China (n = 5041). A: Epileptic patients came from 25 regions of China. Colors from dark to light indicate different proportion of epileptic patients from higher to lower (3 levels: >6%, 3-6%, and <3%). B: People in epidemiological study of headache came from 25 regions of China. Colors from dark to light indicate different proportion from higher to lower (3 levels: >6%, 3-6%, and <3%).