Short-lasting retroorbital pain attacks as a form of ictal epileptic headache: Case report. (August 2019)

• Record Type: Journal Article
• Authors: Viana, Pedro F; Hasegawa, Harumoto; Jarosz, Josef; Siddiqui, Ata; Selway, Richard P; Mullatti, Nandini
• Is Part Of: Cephalalgia. Volume 39:Number 9(2019)
• Page Start: 1195
• Page End: 1199
• Publication Date: 2019-08
• Subjects: Ictal epileptic headache -- cephalic aura -- frontal lobe epilepsy; Headache -- Periodicals; 616.8491
• DOI: 10.1177/0333102419839792
• Languages: English
• ISSNs: 0333-1024

Abstract

Background and objectives: Ictal epileptic headache is a rare form of painful seizure, habitually consisting of migrainous or tension-type headache. We describe a case of a patient with short-lasting, severe retroorbital pain attacks caused by frontal lobe epilepsy. Case report: A 25-year-old male patient presented with recurrent attacks of paroxysmal, short-lasting, excruciating left periorbital and facial pain mainly occurring from sleep. After intracranial EEG exploration and resection of a right prefrontal focal cortical dysplasia, long-term seizure and headache remission was obtained. Discussion: Our case extends the clinical and neuroanatomical spectrum of ictal epileptic headache and suggests that long-term remission can be obtained by resective epilepsy surgery. It also reinforces the role of the prefrontal cortex in the pain matrix and pain generation. Conclusion: Despite its rarity, ictal epileptic headache should be suspected in selected patients, particularly those with other ictal symptoms and signs, history of epileptic seizures, or neuroimaging abnormalities.