Aim: To study the prevalence of headache in patients with epilepsy and their first degree
relatives as compared with controls.
Methods: Consecutive patients, older than 5 years, with active epilepsy attending the epilepsy
clinic and their first-degree relatives were interviewed for the presence and type
of headaches. Patients with mental retardation and communication difficulties were
excluded. Type of headache was classified according to the International Headache
Society Criteria III β. Control group included age- and sex-matched relatives of patients
attending medicine outpatient clinics.
Results: A total of 120 patients (69 males), their first-degree relatives, and equal number
of controls were studied from June to December 2018. Mean age of the patients was
26.5 ± 9.9 years and mean epilepsy duration was 10.3 ± 9.1 years. Of these, 76 (63.3%)
had focal epilepsy and 40 (33.3%) had idiopathic generalized epilepsy. In the epilepsy
group, 72 (60%) patients had interictal headache, 16 (13.3) had postictal headache,
one (0.8%) had ictal headache, while nine (7.5%) patients had both interictal and
postictal headaches. Interictal headache was present in 81 (67.5%) patients (25.8%
migraine, 41.7% tension type headache [TTH]), 62 (51.6%) relatives (24.2% migraine
and 27.5% TTH), and 51 (42.5%) controls (10.8% migraine and 31.7% TTH). All types
of headaches (p = 0.0002) and migraine (p = 0.004) were more common in patients than control wile migraine was also more common
in relatives as compared with controls (p = 0.01).
Conclusion: Migraine is more common in patients with epilepsy and their first-degree relatives
as compared with controls indicating a shared genetic link between epilepsy and migraine.
