A comparison of post-ictal headache between patients with occipital lobe epilepsy and temporal lobe epilepsy

We investigated post-ictal headaches (PIH) using a questionnaire to ascerta in their characteristics and compare them among different types of epilepsy . The subjects consisted of 34 patients with occipital lobe epilepsy (OLE) and 75 patients with temporal lobe epilepsy (TLE). PIH occurred in 62% of O LE and 23% of TLE (P < 0.05). The quality of pain in PIH was 'steady' in 71 % of OLE and 29% of TLE (P < 0.05) as opposed to 'pounding'. Other factors, such as frequency, severity, duration, and accompanying symptoms showed no significant differences. We found very few patients with migraine-like hea daches. Analyses of clinical factors, such as age at onset, duration of epi lepsy, seizure frequency, family history of headache, and interictal headac he did not reveal any relationship to PIH, although generalized tonic-cloni c seizures are associated with PIH in TLE (P < 0.05). These results suggest that the nature of PIH may be different between OLE and TLE, and that the region of epileptic focus or spreading area of epileptic discharge may have a close relation to the induction of PIH. An association with migraine, wh ich has been reported previously, was unclear in our study. (C) 1999 BEA Tr ading Ltd.