Prevalence of primary headache in patients with epilepsy

SUMMARY Consecutive adult patients with epilepsy, referred to our Epilepsy Centre, were recruited to investigate the prevalence of primary headache. All patients had had a definite diagnosis of epilepsy for more than one year. Patients with learning disabilities were excluded. Epilepsy was classified according to the criteria of The International League Against Epilepsy (ILAE). Headache was classified according to the ICHD-II rubrics based on clinical interview. We recruited 923 patients (501 females, 422 males; age 44+19) years with epilepsy. In this population, we identified 311 (33.5%) patients with primary headache: 167 (18%) with migraine; 112 (12%) with tension-type headache. The data concerning the association of epilepsy and migraine are conflicting, but most published studies were done before the ICHD or did not classify their cases according to the ICHD criteria; moreover, previous studies do not consider the prevalence of all primary headaches. Our preliminary study showed a prevalence of migraine in this epileptic population higher than in general population (18 vs 12%).