Leniger T, Isbruch K, von den Driesch S, Diener H C, Hufnagel A
Department of Neurology, University of Essen, Essen, Germany.
Epilepsia. 2001 Sep;42(9):1176-9. doi: 10.1046/j.1528-1157.2001.37500.x.
Headache is often ignored as a symptom of epileptic seizures. The purpose of this prospective study was to analyze frequency, classification, and characteristics of seizure-associated headache (SH) according to the criteria of the International Headache Society.
Over a period of 15 months, 341 patients with epilepsy, consecutively evaluated at our outpatient clinic for SH, completed a standardized questionnaire.
Of the 341 epilepsy patients, 115 (34%) experienced SH with a pain intensity of 6.1 +/- 1.6 (SD) on the visual analogue scale and a duration of 12.8 +/- 15.7 (SD) h. Seizures were always accompanied by headache in 69 (60%) of these 115 patients. SH occurred in four (3%) of 115 patients only preictally, in 31 (27%) of 115 patients periictally, and in 80 (70%) of 115 patients only postictally. In the majority of the 115 patients (55.7%), SH could be classified as migraine headache, whereas in 36.5%, as tension-type headache. The type of SH was not correlated with sex, an epilepsy syndrome, or a seizure type. Migraine-like SH was significantly associated with a history of migraine (p < 0.001). In 20 (77%) of the 26 patients experiencing migraine-like SH with a history of migraine, the phenomenology of migraine-like SH and migraine attacks was identical.
SH is a frequent, long-lasting, and severe symptom of epileptic seizures, causing major impairment of daily living. A history of migraine significantly increases the risk for developing migraine-like SH.
头痛常被忽视作为癫痫发作的一种症状。本前瞻性研究的目的是根据国际头痛协会的标准分析癫痫相关性头痛（SH）的频率、分类及特征。
在15个月的时间里，341例癫痫患者在我们门诊连续接受SH评估，完成一份标准化问卷。
在341例癫痫患者中，115例（34%）经历过SH，视觉模拟量表上疼痛强度为6.1±1.6（标准差），持续时间为12.8±15.7（标准差）小时。在这115例患者中，69例（60%）癫痫发作时总是伴有头痛。115例患者中，4例（3%）仅在发作前出现SH，31例（27%）在发作期间出现，80例（70%）仅在发作后出现。在115例患者中的大多数（55.7%），SH可归类为偏头痛，而36.5%为紧张型头痛。SH的类型与性别、癫痫综合征或发作类型无关。偏头痛样SH与偏头痛病史显著相关（p<0.001）。在26例有偏头痛病史且经历过偏头痛样SH的患者中，20例（77%）偏头痛样SH和偏头痛发作的表现相同。
SH是癫痫发作常见、持久且严重的症状，对日常生活造成重大损害。偏头痛病史显著增加发生偏头痛样SH的风险。
