title: The burden of headache in people with epilepsy.
abstract: OBJECTIVE
  To investigate and classify headaches in adult people with epilepsy, to evaluate the burden of headaches, and to compare findings with a population-based epidemiological study.
  
  
  METHODS
  Two hundred eighty (61.4% women) people with epilepsy (mean age 37.8±14.5, mean duration of epilepsy 13.2±11.9years) completed a questionnaire collecting socio-demographic and clinical data, questions clarifying their type of a headache, a Qolie-10 questionnaire and a Headache-Attributed Lost Time (HALT) index. An experienced neurologist also interviewed them.
  
  
  RESULTS
  83.2% of respondents reported some type of headache. From those with inter-ictal headaches (77.9%), 39% reported tension-type headache, 31.7% reported migraine, and 7.8% reported medication-overuse headache and 16% reported possible persistent headache attributed to traumatic head injury. The impact of headache assessed through the HALT grading showed that 40.4% were grade 1, 9.6% grade 2, 14.7% grade 3 and 35.3% grade 4. Although, the prevalences of different headache types were similar to those in our population-based study, migraine seemed to be more common in males with epilepsy than in general population, and medication-overuse headache was more common in people with epilepsy than in the general population.
  
  
  CONCLUSIONS
  People with epilepsy experience headaches irrespective of their sex or age. The burden of headaches is very important in patients with epilepsy, since headaches usually cause a moderate or severe burden to their quality of life and suggest a clear clinical need. Clinicians should recognize headache as a common comorbidity of epilepsy, as it may influence antiepileptic drug choice, and may need specific treatment.
authors.affiliation: Vilnius University, Department of Neurology and Neurosurgery, Center for Neurology, Vilnius, Lithuania. Electronic address: ruta.mameniskiene@santa.lt.
authors.forename: R
authors.initials: R
authors.lastname: Mameniškienė
authors.affiliation: Faculty of Medicine, Vilnius University, Vilnius, Lithuania. Electronic address: irute.karmonaite@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Karmonaitė
authors.affiliation: Faculty of Medicine, Vilnius University, Vilnius, Lithuania. Electronic address: rimantas.zagorskis@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Zagorskis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006261:Headache / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
keywords: Epilepsy; HALT index; Headache; Migraine; Qolie-10