Ictal headache: Insights from two cases. (November 2018)

• Record Type: Journal Article
• Authors: Taga, Arens; Florindo, Irene
• Is Part Of: Cephalalgia. Volume 38:Number 13(2018)
• Page Start: 1972
• Page End: 1975
• Publication Date: 2018-11
• Subjects: Glossopharyngeal neuralgia -- SUNCT -- ictal headache -- epilepsy -- cortical pain processing; Headache -- Periodicals; 616.8491
• DOI: 10.1177/0333102418758281
• Languages: English
• ISSNs: 0333-1024

Abstract

Background: We report the first literature description of ictal epileptic headaches closely mimicking glossopharyngeal neuralgia and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Case 1: A 37-year-old man complained of short-lasting, electric-shock like headache, confined to the pharynx. During the episodes, he could not speak because he felt "words blocked at the throat". An EEG recorded epileptic discharges concomitant with headache; a brain MRI disclosed frontal polymicrogyria. Case 2: A 66-year-old man complained of short-lasting, right periocular headache, associated with ipsilateral ptosis, conjunctival injection and lacrimation. Some episodes were followed by tonic contraction of the right facial and limb muscles; on one occasion, headache was followed by a generalized seizure. A brain MRI revealed hippocampal abnormalities. Discussion: These cases highlight the complex relationship between headache and epilepsy, and suggest a possible contribution of cortical structures to the genesis of paroxysmal headaches such as glossopharyngeal neuralgia and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing.