Parisi Pasquale, Paolino Maria Chiara, Raucci Umberto, Della Vecchia Nicoletta, Belcastro Vincenzo, Villa Maria Pia, Striano Pasquale
Chair of Pediatrics, Child Neurology, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Front Neurol. 2019 Jul 23;10:785. doi: 10.3389/fneur.2019.00785. eCollection 2019.
The relationship between headache and epilepsy is complex and despite the nature of this association is not yet clear. In the last few years, it has been progressively introduced the concept of the "ictal epileptic headache" that was included in the recently revised International Classification of Headaches Disorders 3rd edition (ICHD-3-revised). The diagnostic criteria for ictal epileptic headache (IEH) suggested in 2012 were quite restrictive thus leading to the underestimation of this phenomenon. However, these criteria have not yet been included into the ICHD-3 revision published in 2018, thus creating confusion among both, physicians and experts in this field. Here, we highlight the importance to strictly apply the original IEH criteria explaining the reasons through the analysis of the clinical, historical, epidemiological and pathophysiological characteristics of the IEH itself. In addition, we discuss the issues related to the neurophysiopathological link between headache and epilepsy as well as to the classification of these epileptic events as "autonomic seizure."
头痛与癫痫之间的关系很复杂，尽管这种关联的本质尚不清楚。在过去几年中，“发作性癫痫性头痛”的概念逐渐被引入，该概念已被纳入最近修订的《国际头痛疾病分类》第三版（ICHD-3修订版）。2012年提出的发作性癫痫性头痛（IEH）的诊断标准相当严格，因此导致对这一现象的低估。然而，这些标准尚未纳入2018年出版的ICHD-3修订版，从而在该领域的医生和专家中造成了混乱。在此，我们强调严格应用原始IEH标准的重要性，并通过分析IEH本身的临床、病史、流行病学和病理生理学特征来解释原因。此外，我们还讨论了与头痛和癫痫之间的神经生理病理联系以及将这些癫痫事件归类为“自主神经发作”相关的问题。
