Postictal headache

Postictal headache (PIH) is defined by the International Classification of Headache Disorders as “headache with features of tension-type headache or, in a patient with migraine, of migraine headache, which develops within 3 hours following a partial or generalized seizure and resolves within 72 hours after the seizure.” PIHs are prevalent, moderate to severe in intensity, last many hours, and frequently have characteristics of migraine. Young adults with a history of interictal headaches are at increased risk of developing PIH. Young age at onset and long duration of epilepsy, drug-resistant seizures, generalized tonic–clonic seizures, and possibly an occipital epileptic focus are additional risk factors. Although PIH is estimated to have a significant impact on the quality of life of people with epilepsy, it is frequently undertreated. Simple analgesics may prove beneficial. Epilepsy and headache share common pathophysiological mechanisms, as suggested by clinical and investigational findings, although the exact processes underlying these conditions are still largely unknown.