headacheA study has found that headaches cause a ‘burden’ to the quality of life of many people with epilepsy.

The study, conducted by scientists from Vilnius University in Lithuania sought to investigate and classify headaches in adults with epilepsy.

Researchers sampled a group of 280 people who had been diagnosed with epilepsy for around 12 years, of whom 61.4 per cent were women. 

Type of headache

Study participants completed a questionnaire collecting socio-demographic and clinical data, as well as clarifying their type of a headache.  Each participant completed a Quality of life in epilepsy (Qolie-10) questionnaire and a Headache-Attributed Lost Time (HALT) index.  An experienced neurologist also interviewed each study participant.

Researchers found that 83.2 per cent of respondents reported some sort of headache.  They found that 77.9 per cent of participants had inter-ictal headaches, of whom 39 per cent reported tension headache, and 31.7 per cent reported migraine.  Nearly 8 per cent had medication-overuse headache, while 16 per cent reported having persistent headache possibly caused by traumatic head injury.

The HALT grading showed the impact of headache experienced, where grade 1 is low impact, and grade 4 is severe.  Researchers found that half of people with epilepsy studied have 3rd or 4th grade of HALT index headache severity.

Epilepsy drugs and headaches

Medical director at Epilepsy Society, Professor Ley Sander, commented: ‘The link between epilepsy and migraine is well known but not fully understood. As clinicians we should be sensitive to the potential prevalence of both in a person and treat them accordingly.

‘Some of the most commonly prescribed epilepsy medications can result in headaches as a side effect for some people. Anyone experiencing this should tell their doctor so that an assessment can be made if it there is a link with the medication and, if necessary, a change of dose or a change of medication can be considered.’

Researchers also found that, while headache prevalence was generally similar among people with epilepsy and the general population, migraine was more common in males with epilepsy, and medication-overuse headache was more common in people with epilepsy than in the general population.

Specific treatment

The study, published in Seizure journal concluded that people with epilepsy experience headaches irrespective of their sex or age. “The burden of headaches is very important in patients with epilepsy, since headaches usually cause a moderate or severe burden to their quality of life and suggest a clear clinical need.”

The study authors recommend that clinicians should recognize headache as a common co-morbidity of epilepsy, that may influence anti-epileptic drug choice, and may need specific treatment.

Source: Epilepsy Society UK