title: Ictal headache: headache as first ictal symptom in focal epilepsy.
abstract: Headache may be associated with seizures as a preictal, ictal, or postictal phenomenon, but it is often neglected because of the dramatic neurological manifestations of the seizure. Headache can also be the sole or predominant clinical manifestation of epileptic seizures, although this is a relatively rare condition. We describe two cases of focal symptomatic drug-resistant epilepsy with headache as the first ictal symptom. In both cases, the headache, which lasted a few seconds, was contralateral to the ictal discharge and did not have the clinical features of migraine. Ictal headache is a rare epilepsy symptom that can help to localize ictal EEG discharges. Recently, the term ictal epileptic headache has been proposed in cases in which headache is the sole ictal epileptic manifestation Diagnosis requires the simultaneous onset of headache with EEG-demonstrated ictal discharges.
authors.affiliation: Epilepsy Centre, Neurologic Division, Hospital of Venice, Venice, Italy. fdainese@gmail.com
authors.forename: Filippo
authors.initials: F
authors.lastname: Dainese
authors.forename: Roberto
authors.initials: R
authors.lastname: Mai
authors.forename: Stefano
authors.initials: S
authors.lastname: Francione
authors.forename: Federico
authors.initials: F
authors.lastname: Mainardi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Zanchin
authors.forename: Francesco
authors.initials: F
authors.lastname: Paladin
mesh_terms: D002648:Child; D004569:Electroencephalography / Q000379:methods; D004828:Epilepsies, Partial / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged