关键词: Ictal epileptic headache cephalic aura frontal lobe epilepsy

Mesh : Adult Electroencephalography Epilepsy, Frontal Lobe / complications diagnosis surgery Headache / etiology Humans Magnetic Resonance Imaging Male Malformations of Cortical Development / complications diagnosis surgery Seizures / etiology

来  源:   DOI:10.1177/0333102419839792   PDF(Sci-hub)

Abstract:
OBJECTIVE: Ictal epileptic headache is a rare form of painful seizure, habitually consisting of migrainous or tension-type headache. We describe a case of a patient with short-lasting, severe retroorbital pain attacks caused by frontal lobe epilepsy.
METHODS: A 25-year-old male patient presented with recurrent attacks of paroxysmal, short-lasting, excruciating left periorbital and facial pain mainly occurring from sleep. After intracranial EEG exploration and resection of a right prefrontal focal cortical dysplasia, long-term seizure and headache remission was obtained.
CONCLUSIONS: Our case extends the clinical and neuroanatomical spectrum of ictal epileptic headache and suggests that long-term remission can be obtained by resective epilepsy surgery. It also reinforces the role of the prefrontal cortex in the pain matrix and pain generation.
CONCLUSIONS: Despite its rarity, ictal epileptic headache should be suspected in selected patients, particularly those with other ictal symptoms and signs, history of epileptic seizures, or neuroimaging abnormalities.
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