Abstracts

Rationale: Epilepsy, headache and migraine are among the most prevalent neurological conditions and these relationships have long been recognized. However there are few controlled studies evaluating at the same time the prevalence of different types of headache in epilepsy. In this study we evaluate the prevalence of different types of headache in adult patients with epilepsy accessing if epilepsy would be an isolated risk factor for these forms of headache. Methods: Our study is a case-control study evaluating the prevalence of tension type headache, migraine, or other types of headache in 175 patients with epilepsy and 189 respective controls. Neurologists experienced in headache evaluated patients with epilepsy and controls for headache episodes during the previous year. Clinical characteristics, neurophysiological studies and neuroimaging data of patients with epilepsy were also analyzed. Variables studied in both groups, patients with epilepsy and respective controls were sex, age, time at school, and type of professional activity. After univariated analysis, a multinominal logistic regression model was utilized to evaluate if epilepsy would be an isolated risk factor for different types of headache. Results: In our study, 39% of controls and 75% of patients with epilepsy had history of headache, a significant difference (O.R. = 4.75; 95% CI = 3.04-7.44; p<0.0001). Migraine was present in 17.1% of control individuals and in 40.2% of patients with epilepsy, a significant difference (OR=3.25, IC 95%=1.99-5.30, p<0.001). The frequency of other forms of headaches was slightly higher in patients with epilepsy when compared with control group, but the difference was not statistically significant. After multinominal logistic regression epilepsy emerged as an independent risk factor for tension type headache (O.R. = 6.58; 95% CI = 3.21-13.51; p<0.0001), migraine (O.R. = 5.55; 95% CI = 3.22-9.61; p<0.0001), as well as other types of headache (O.R. = 2.60; 95% CI = 1.39-4.88; p=0.003). Conclusions: In line with previous findings we observed an increased frequency of headache in patients with epilepsy. Moreover, we observed also that epilepsy was an isolated risk factor for tension type headache, migraine, as well as other types of headaches. Further studies are necessary to elucidate better the different mechanisms involved in the association between epilepsy and tension type headache, epilepsy and migraine, and epilepsy and other types of headaches. However, further studies are also necessary to delineate common mechanisms for different types of headaches in epilepsy. This work was supported by CNPq.