EPILEPSY AND HEADACHE: CLINICAL PATTERNS, PATHOPHYSIOLOGICAL LINKS, AND COMORBIDITY

Аннотация

Headache is a common and clinically significant comorbid condition in patients with epilepsy. Depending on its temporal relationship with epileptic seizures, headache may be classified as interictal or periictal, including preictal, ictal, and postictal forms. Numerous studies indicate that migraine is the most frequent headache phenotype in epilepsy, reflecting shared clinical characteristics and overlapping pathophysiological mechanisms, such as cortical hyperexcitability, neurotransmitter imbalance, ion channel dysfunction, and genetic susceptibility. The concept of migralepsy, previously used to describe epileptic seizures triggered by migraine aura, has been revised in modern classifications, which now emphasize precise electroclinical correlations. Other primary headaches, particularly tension-type headache, are also observed in epilepsy, although their development appears to be more closely related to psychosocial factors, including chronic stress, depression, and disease-related stigma. Understanding the complex relationship between epilepsy and headache is essential for accurate diagnosis and for optimizing therapeutic strategies aimed at improving seizure control and quality of life.