Structured interviews regarding peri-ictal
headaches and personal or family histories of interictal
headaches were conducted on 101 children (aged 5-18 years), with generalized tonic-clonic or
partial seizures.
Epilepsy-specific details were collected by interviews and reviews of neurology clinic charts. Peri-ictal
headaches were reported by 41% (29%, postictal only; 5%, preictal only; 7%, both). Clear migrainous features were present in 50% of preictal and 58% of postictal
headaches. Most children described
bilateral headaches. No demographic or
epilepsy-specific correlates were identified that predicted peri-ictal
headaches. Interictal
headaches occurred in 24%, with 14% of children meeting criteria for
migraines. However, neither interictal
migraines nor a positive family history of
migraines was significantly predictive of either peri-ictal
headaches or migrainous peri-ictal
headaches. Postictal
headaches occurred reliably after most
seizures in predisposed children, and interrupted activities in the majority. Whereas only half of children received abortive medications for these
headaches, simple
analgesics were effective in most cases. We conclude that peri-ictal
headaches are common, affecting 41% of children with
epilepsy. Their presence should be routinely queried, and if documented, treatment with simple
analgesics appears beneficial and should be considered.