Neurological Sciences

, Volume 38, Issue 6, pp 941–948 | Cite as

The complex interrelations between two paroxysmal disorders: headache and epilepsy

  • Carlo CianchettiEmail author
  • Giuliano Avanzini
  • Filippo Dainese
  • Vincenzo Guidetti
Review Article


The interrelations between headache/migraine and epileptic seizures are an interesting topic, still lacking a systematization, which is the objective of the present revision. We organize the general setting on: (a) a distinction between pre-ictal, ictal, post-ictal and inter-ictal headaches, assuming “ictal” as epileptic seizure, and (b) the kind of headache, if it is of migraine type or not. Concerning pre-ictal migraine/headache, the necessity of its differentiation from an epileptic headache presenting as an aura of a seizure is stressed; this is connected with the indefiniteness of the term “migralepsy”. The term “migraine aura-triggered seizure” should be used only in front of a proven triggering effect of migraine. Epileptic headache (called also “ictal epileptic headache”) is a well-characterized entity, in which different types of head pain may occur and an ictal EEG is necessary for the diagnosis. It may present as an isolated event (“isolated epileptic headache”), requiring a differential diagnosis from other kinds of headache, or it may be uninterruptedly followed by other epileptic manifestations being in this case easily identifiable as an epileptic aura. Hemicrania epileptica is a very rare variant of epileptic headache, characterized by the ipsilaterality of head pain and EEG paroxysms. Ictal non-epileptic headache needs to be differentiated from epileptic headache. Post-ictal headaches are a frequent association of headache with seizures, particularly in patients suffering also from inter-ictal headache-migraine. The reported systematization of the topic led us to suggest a classification which is shown in Appendix.


Headache Migraine Epilepsy Epileptic headache Ictal epileptic headache Hemicrania epileptica Migralepsy 


Compliance with ethical standards

Conflict of interest

None of the authors has any conflict of interest to disclose.


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Copyright information

© Springer-Verlag Italia 2017

Authors and Affiliations

  1. 1.Former Professor of Child and Adolescent Neurology and PsychiatryUniversity of CagliariCagliariItaly
  2. 2.Department of Neurophysiology and Epilepsy UnitBesta Neurological InstituteMilanItaly
  3. 3.Neurologic Unit, Epilepsy CenterSS.Giovanni e Paolo HospitalVeniceItaly
  4. 4.Child and Adolescent NeuropsychiatrySapienza UniversityRomeItaly

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