Abstracts

Rationale: The frequency of headache among persons with epilepsy (PWE) has been manifested as 48.4% in a systemic review and meta-analysis. Although the brain hyperexcitability associated with seizures suggested as triggering peri-ictal headache via the activation of trigeminovascular system, the exact nature of interictal headache has not been identified.

Methods: We asked patients who consecutively visited our epilepsy clinic whether they experienced headaches in the past month. Patients who had a peri-ictal headache, defined as a headache occurred within 24 hours before epileptic attacks and within 72 hours after these events, were excluded from the study. We divided patients into two groups (in relation to headache frequency) as follows: infrequent headache (< 5 days/month) and frequent headache (≥ 5 days/month). We conducted the Neurological Disorders Depression Inventory for Epilepsy and Generalized Anxiety Disorder-7.

Results: We found that 615 patients experienced headaches in the past month. Among them, 470 (76.4%) had interictal headache. In the univariate analysis, gender, age at onset, disease duration, anti-seizure medication (ASM) year, ASM regimen, ASM inducing headache, seizure control, depression, and anxiety were significantly associated with headache frequency. In the multivariate analysis, the most important risk factors were depression (OR=5.840, 95% CI 3.360-10.151, p< 0.001) and seizure control (OR=1.834, 95% CI 1.059-3.176, p=0.03).

Conclusions: A frequent interictal headache in PWE suggests the existence of mood disorders and poor seizure control.

Funding: None