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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 3/2017

01-03-2017 | Secondary Headache (M Robbins, Section Editor)

The Relationship Between Headaches with Epileptic and Non-epileptic Seizures: a Narrative Review

Authors: William S. Kingston, Todd J. Schwedt

Published in: Current Pain and Headache Reports | Issue 3/2017

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Abstract

Purpose of Review

The purpose of this review is to examine the relationship between headaches and epilepsy as well as headaches and psychogenic non-epileptic seizures (PNES). Emphasis was placed on clinical characteristics, pathophysiology, and treatment.

Recent Findings

Epilepsy and headaches are common disorders that co-occur more often than would be expected by chance. There are some overlapping clinical features between migraine and epilepsy as well as evidence for shared underlying mechanisms. Proposed theories for a shared etiology include ion channel dysfunction, glutamatergic mechanisms, and mitochondrial dysfunction. Some, but not all, recent diagnostic classification systems have recognized the relationship between headaches and epilepsy. Ictal headaches are rare and should raise suspicion for PNES. Headaches in patients with epilepsy are undertreated despite evidence for efficacy of abortive headache medications.

Summary

Comorbid headaches and epilepsy are relatively common in the population presenting to a neurologist. Patients who have headaches and epilepsy and/or PNES should receive appropriate treatment that often includes mutually beneficial preventative therapy and includes abortive headache treatment.
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Metadata
Title
The Relationship Between Headaches with Epileptic and Non-epileptic Seizures: a Narrative Review
Authors
William S. Kingston
Todd J. Schwedt
Publication date
01-03-2017
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 3/2017
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-017-0617-9

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