Abstracts

Rationale: Purpose In general population the prevalence of headache was estimated to 16% in female and 6% in male. It is well- known the increased possibility of headache in patient with epilepsy at around 30-70% and the occurrence of headache are mostly in postictal and interictal period; only rarely during ictal period. Epilepsy and chronic headache both are heterogeneous disorder sharing the well known paroxysmal character and behave good daily activity in illness free time. Some reports had told us there are common mechanisms between these two disorders and most of the epidemiological association researches were focusing on per-ictal headache. In this study, we aim to delineate the long term association between the beginning of the diagnosis of chronic headache and epilepsy. Methods: Methods: Study design and sample. This study adapted the feature extracted data base from the Bureau of National Health Insurance (NHI), implemented in Taiwan in March 1995 with the coverage rate of more than 98% since 1998. The National Health Research Institutes (NHRI) established a random sample with a representative population of 1,000,000 persons (approximately 4.2% of all insured persons) with the 2005 insured population. The population selected is similar to all insured enrollees in sex and age distribution. 2306 patients with epilepsy were randomly identified from 1996 to 2005 and another 2306 patients without epilepsy as controlled group. 446 chronic headache cases with epilepsy beginning from 1998 to 2005 were indentified and analyzed the timeline association of the onset of headache and epilepsy. Results: 900 cases with chronic headache were identified in epilepsy group and 679 cases control group with statistic significant difference. The diagnosis of chronic headache case numbers was shown to increase while approaching the timing of epilepsy emergence and gradually decline after the diagnosis of epilepsy. Conclusions: Headache inclusion in this study was supposed to encompass both tension type and migrainous headache in diagnosis of either peri-ictal and interictal headache in consideration of temporal relationship to seizure. Patient with epilepsy were inclined to have significant headache and called for physician's help. The emergence of chronic headache was significantly more likely to be associated with the beginning of epilepsy that imply the common pathophysiology underling these 2 disorders that remained to be verified.