Hippocampal sclerosis and ipsilateral headache among mesial temporal lobe epilepsy patients

Seizure. 2011 Jul;20(6):480-4. doi: 10.1016/j.seizure.2011.02.014. Epub 2011 Mar 24.

Abstract

Purpose: To investigate the frequency and patterns of headache in a well-defined and homogeneous group of mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) patients.

Methods: One hundred consecutive MTLE-HS patients under comprehensive presurgical evaluation were evaluated from May 2009 to April 2010. A standardized questionnaire was applied according to the criteria of the International Headache Society (IHS). Headache diagnosis was based on the second edition of the International Classification of Headache Disorders (ICHD-II).

Results: Ninety-two patients (92%) had at least one headache episode during the previous 12 months. Migraine occurred in 51.9% of patients and tension-type headache (TTH) in 39.1%. Patients with migraine presented higher frequency (p=0.002) and severity of episodes (p<0.001), as well as lateralized pain (p=0.001) than individuals with TTH. MTLE-HS patients with unilateral HS and predominantly unilateral headache (irrespective of the type), presented pain ipsilateral to the HS (OR 8.5; CI 95%=2.1-35.1; p=0.003).

Conclusions: Headache is a frequent clinical symptom of lateralizing value, which may share common pathophysiology with epileptogenesis among MTLE-HS patients.

MeSH terms

  • Adult
  • Age of Onset
  • Anticonvulsants / therapeutic use
  • Cross-Sectional Studies
  • Educational Status
  • Electroencephalography
  • Epilepsy, Temporal Lobe / complications
  • Epilepsy, Temporal Lobe / pathology*
  • Epilepsy, Temporal Lobe / physiopathology
  • Epilepsy, Temporal Lobe / therapy
  • Female
  • Functional Laterality
  • Headache / etiology*
  • Headache / physiopathology
  • Hippocampus / pathology*
  • Hippocampus / physiopathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Sclerosis
  • Socioeconomic Factors
  • Valproic Acid / therapeutic use

Substances

  • Anticonvulsants
  • Valproic Acid