CLINICAL EVALUATION OF HEADACHE IN PATIENTS WITH EPILEPSY IN A TERTIARY CARE HOSPITAL
Journal Title: Stanley Medical Journal - Year 2016, Vol 3, Issue 4
Abstract
Aim: The aim of the study is to analyse and classify headaches occurring in patients with epilepsy and study the pattern of headaches associated with different types of epilepsies . Setting and design : It is a Cross Sectional Descriptive study of Patients with epilepsy who have headache either interictally or periictally or both were taken up for the study. Materials and Methods Study Design: Cross Sectional Descriptive study. Study Population: Patients with epilepsy who have headache either interictally or peri ictally or both who attended Neurology O.P. Government General Hospital, Chennai during the study period (July 2003 to August 2005) were taken up for the study. Inclusion Criteria: Patients with epilepsy who have inter ictal headache of >3 months duration antecedent to or after the onset of seizures and Patients with epilepsy who have peri ictal headache Exclusion Criteria: Patients with epilepsy who developed sudden onset severe headache, headache with systemic signs such as fever, neck stiffness, cutaneous rash, headache with papilloedema, headache triggered by cough, exertion or valsalva maneuver were excluded from the study. Patients with epilepsy who have either interictal or perictal headaches who did not have any features of exclusion criteria were selected for the study. Statistical analysis used : SPSS software Results : The total number of patients studied were 124 of which males comprised 33% (n=42) and females 66% (n= 82). The most common type of seizures seen were generalised tonic clonic seizures which is 42% of patients (n=52) and 38.7% of patients (n=48) have secondary generalised tonic-clonic seizures. Among 48 patients with 2*GTCS, 27 cases were of simple partial seizures with secondary generalisation and 21 were of complex partial in nature with secondary generalization. Interictal headache was present in 82 patients (66.6%) and seizure associated headache in 42 patients (33.4%) with epilepsy. Among 77 patients with primary headache, migraine type headache was seen in 54% (n=45) of patients and Tension type headache occurred in 30.4% (n=25) of patients, Episodic cluster headache was seen in one patient and primary stabbing headache was seen in 6 patients with epilepsy. Secondary headache was seen in 6% (n=5) of patients with epilepsy. Among 42 patients with seizure associated headache, 24 (19.3%) had headache which might be an ictus without accompanying seizure activity classified as headache which could not be elsewhere classified (14.1) and 18 had (14.5%) pre ictal, ictal or post ictal headache. Conclusion : The most common type of seizures seen in patients with headache is primary generalized tonic-clonic seizures with primary headache seen in 94% of patients and secondary headache in the remaining. Migraine without aura type of headache is the most common primary headache seen interictally in patients with epilepsy. There is no specific correlation between headache subtype and type of epilepsy. Seizure associated headaches is seen in 14.5% of patients either as pre ictal, ictal or post ictal headache
Authors and Affiliations
Mugundhan K, Ramakrishnan T. C. R
Keywords
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