Pattern, frequency, and correlates of seizure-related headache in Enugu, Southeast Nigeria

Introduction: The association of headache and epilepsy has long been recognized in clinical practice. Primary headache, especially migraine, is episodic and shares common genetic and pathologic pathways. Current definition of epilepsy underscores the impact of other neurologic comorbidities such as headache in the burden of epilepsy. There is a paucity of data on seizure-related headache in Nigeria. Objectives: The objectives of this study were to describe the pattern and correlates of seizure-related headache among people with epilepsy (PWE) attending medical outpatient clinics in Enugu, Southeast Nigeria. Materials and Methods: Data were collected from the epilepsy register of PWE attending medical outpatient clinics in two teaching hospitals in Enugu. Data were analyzed using the SPSS statistical software. Results: The overall prevalence of headache among PWE was 48% (73/152). A history of migraine was reported in 3 (2%) of the patients. The commonest form of headache was postictal headache 24 (15.8%). Preictal headache was reported by 16 (10.5%), out of which 4 (4.5%) were reported as possible auras. Headache pain was mainly aching 44 (60.3%) and generalized 41 (56.2%). Seizure-related headaches correlated with medical history of alcohol use (P = 0.04). Positive history of head injury and epilepsy-related head injury weakly correlated with having headache (P = 0.07), respectively. Conclusion: PWE often have seizure-related headaches. Such headaches occur mainly after seizures. Careful evaluation of PWE should include the burden and impact of headache in the lives of these patients.