• Pasquale Parisi, Pasquale Striano, Alberto Verrotti, Maria Pia Villa, and Vincenzo Belcastro.
• Child Neurology, Headache Paediatric Center, Paediatric Sleep Disorders, Chair of Paediatrics, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, c/o Sant'Andrea Hospital, Rome, Italy. pasquale.parisi@uniroma1.it
• Seizure. 2013 May 1;22(4):253-8.

PurposeThe case report published in this issue by Wang et al. offers us an opportunity to review previously published "ictal epileptic headache" cases and draw attention to the criteria that have recently been published for this condition, taking into consideration not only the clinical-EEG and physiopathogenetic investigations required to diagnose this condition, but also the therapeutic aspects of the issue.MethodsTo this aim we reviewed all well-documented cases that have been reported in the literature.ResultsThe relationship between headache and seizures is somewhat complicated. Although the nature of this association is not yet fully clear, several plausible explanations have been proposed. Further experimental and clinical investigations are, however, warranted to gain a better understanding of this relationship. Epilepsy and idiopathic headache/migraine share several pathophysiological mechanisms; a better understanding of these mechanisms will allow us to more accurately to assess the "real burden" and prevalence of the "ictal epileptic headache" phenomenon and its therapeutic implications.ConclusionsThe development of animal models and molecular studies and, above all, multicenter clinical studies conducted according to the proposed IEH criteria represent the starting point for a definitive international consensus on this intriguing topic. In addition, to improve the recognition of ictal epileptic headache, we should encourage the use of EEG recording in the emergency setting.Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

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