The characteristics of headache in patients with epilepsy

Background Headache is a known comorbid condition of epilepsy. However, the prevalence of headache comorbidity in patients with epilepsy and its influence on the psychology and daily life of patients with epilepsy remain undefined at present. Methods Clinical data were collected from consecutive patients with epilepsy prospectively through face-to-face questionnaires. According to the temporal relationship between headache and seizures, comorbid headache in patients with epilepsy was classified as preictal headache, ictal headache, postictal headache, and interictal headache. Patients with interictal headache were divided into the migraine group and the non-migraine group, and their clinical characteristics were compared with those of patients with epilepsy but without headache (no-headache group). Results A total of 460 patients with epilepsy were included in the study, and 211 (45.9%) had comorbid headache, among which five cases (1.1%) had preictal headache, 134 cases (29.1%) had postictal headache, 119 cases (25.9%) had interictal headache, and 47 cases (10.2%) had both postictal and interictal headache. Additionally, HAMA and HAMD scores in the migraine group were significantly higher than those in the non-migraine group and the no-headache group, and HIT-6 score in the migraine group was significantly higher than that in the non-migraine group. Conclusion Nearly half of patients with epilepsy have comorbid headache, mainly manifesting as postictal headache or interictal headache. Among patients with interictal headache, comorbid migraine has the most significant influence on their psychological state and daily life.