European journal of neurology : the official journal of the European Federation of Neurological Societies
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Interictal headache (IIH), and in particular migraine, is considered a relevant co-morbidity in epilepsy; however, available data are ambiguous. Periictal headache (PIH) displays a frequent ancillary burden to seizures, but identification of unequivocal predictors is still elusive. ⋯ In patients with epilepsy, IIH, and particularly migraine, is less common than expected, challenging the widely held concept of co-morbidity of the two conditions. PIH is frequent, severe and undertreated. Predictors include low age at epilepsy onset, AED polytherapy and tonic-clonic generalized seizures. Physicians should ask for PIH and offer specific analgesic treatment. To confirm these findings, future studies with a prospective approach implementing a headache and seizure diary should be performed.