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The Complex Relationship Between Epilepsy And Headache And The Concept Of Ictal Epileptic Headache

P. Parisi
Published 2015 · Medicine

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Since William Richard Gowers’ time, for over a hundred years, it has been discussing the possible link/comorbidity (causal or not causal) between epilepsy and headaches. During the latest decades, new data have emerged in favor of a non-random relationship between these two entities. They are both characterized by transient attacks of altered brain function with a clinical, pathophysiological, common genetic factors and therapeutic overlap, thus, they may also mimic each other. In fact, the clinical distinction between headache and epilepsy can be so difficult to make the differential diagnosis sometimes highly problematic. Both are common, often co-morbid and, in this latter case, headache attacks can be temporally related with the occurrence of epileptic seizures as pre-ictal, ictal, post-ictal or inter-ictal phenomenon. Yet, they are both paroxysmal and chronic neurological disorders that share many clinical and epidemiological aspects, and they may, both, present with visual, cognitive, sensitive-sensorial and motor signs/symptoms; these neurophysiologic phenomenon arise from the cerebral cortex and are modulated by sub-cortical connections.
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