Headache and Epilepsy
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Headache and epilepsy often co-occur. Epidemiologic studies conducted in the past few years reinforce the notion of a bi-directional association between migraine and epilepsy. Data on an association between headache (in general) and epilepsy, however, are less clear. Peri-ictal headache often presents with migraine-like symptoms and can be severe. A correct diagnosis and management are paramount. It was demonstrated that cortical hyperexcitability may underlie both epilepsy and migraine. A recent study linked spreading depolarisation, the supposed underlying pathophysiological mechanism of migraine with aura, to epilepsy. Although this study was carried out in patients who had suffered a subarachnoid haemorrhage, the finding may shed light on pathophysiological mechanisms common to epilepsy and migraine.
KeywordsHeadache Migraine Epilepsy Post-ictal headache Peri-ictal headache Migralepsy Ictal headache Cortical excitability Familial hemiplegic migraine Cortical spreading depression Cortical spreading depolarisation
This work was supported by the Christelijke Vereniging voor de Verpleging van Lijders aan Epilepsie (Nederland).
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Prisca R Bauer reported no potential conflicts of interest relevant to this article.
Dr. Johannes A. Carpay reported no potential conflicts of interest relevant to this article.
Dr. Gisela M Terwindt reported receiving a grant from the Netherlands Organization for Scientific Research (#VIDI 917-11-319).
Dr. Josemir W Sander reported serving as a board member for GSK, UCB, and Viropharma. Dr. Sander received consultancies from UCB Pharma and GSK. Dr. Sander has receiving grants/grants pending from Eisai, UCB Pharma, and WHO. Dr. Sander has receiving payment for serving on speakers’ bureaus from UCB and GSK and travel/accommodations reimbursed or covered by Janssen Cilag and UCB. Dr. Sander’s current position is endowed by the Epilepsy Society and he serves as an Editorial Board member of the Lancet Neurology.
Dr. Roland J. Thijs reported no potential conflicts of interest relevant to this article.
Dr. Joost Haan reported serving as a board member for Merck Holland (stopped 1-1-2013).
Dr. Gerhard H Visser reported no potential conflicts of interest relevant to this article.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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