Ictal headache and visual sensitivity

Authors: Piccioli, M¹; Parisi, P²; Tisei, P¹; Villa, MP²; Buttinelli, C¹; Kasteleijn-Nolst Trenité, DGA

Source: Cephalalgia, Volume 29, Number 2, February 2009 , pp. 194-203(10)

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Abstract:

Piccioli M, Parisi P, Tisei P, Villa MP, Buttinelli C & Kasteleijn-Nolst Trenité DGA. Ictal headache and visual sensitivity. Cephalalgia 2009; 29:194-203. London. ISSN 0333-1024

Migrainous headache is reported by patients with photosensitive epilepsy, whereas their relatives complain more often about headache than the relatives of patients with other types of epilepsy. We therefore investigated whether headache itself could be an epileptic symptom related to photosensitivity. Four probands with headache and photosensitive epilepsy were selected. Their first-degree family members were studied using video-EEG with extensive intermittent photic stimulation and pattern stimulation. Nine of the 12 subjects (10 female and two male, mean age 30 years, range 14-46 years) proved to be photosensitive with either focal (n = 5) or generalized (n = 4) epileptiform discharges. In two subjects an ictal recording of headache occurred after visual stimulation. We found evidence that, in specific patients, headache could be an ictal sign of epilepsy. Photic stimulation during EEG recording can contribute to correct diagnosis and lead to the best care and management of the patient.

Keywords: Headache; migraine; photosensitive epilepsy; occipital epilepsy; PPR; EEG

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1468-2982.2008.01707.x

Affiliations: 1: Department of Neurology and 2: Child Neurology Section, Paediatric Sleep Centre & Paediatric Headache Centre—Chair of Paediatrics—II Faculty of Medicine, `La Sapienza' University, Rome, Italy, and

Publication date: 2009-02-01