Postictal headache in epileptic patients

Postictal headache (PIH) is defined by the International Classification of Headache Disorders, third edition beta (ICHD-3 beta), as “headache caused by and occurring within 3 hours after an epileptic seizure, and remitting spontaneously within 72 hours after seizure termination”. People at highest risk of suffering PIH are who have generalized tonic-seizures (GTCSs) and a history of interictal headaches. An occipital epileptogenic focus may be an additional risk factor. Also PIH frequently have characteristics of migraine, the diagnostic criteria of “headache with features of tension-type headache or, in a patient with migraine, of migraine headache” in ICHD-2 has been ruled out from the ICDH-3. The high percentage of PIH in patients with epilepsy which really burden patient’s daily life. For purposes of comparison, trials should adhere to a unified definition of PIH, and ICHD-3 beta revised the ICHD-2 definition which widens the inclusion criteria to any headache attributed to a seizure and following it. In order to improve the diagnosis and management of this symptom, clinicians should pay more attention to epileptic patients with PIH.