Headache in idiopathic/genetic epilepsy: Cluster analysis in a large cohort.
cluster analysis
genetic epilepsy
headache
headache phenotypes
idiopathic epilepsy
myoclonic seizures
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
17
02
2022
received:
17
10
2021
accepted:
17
02
2022
pubmed:
22
2
2022
medline:
7
6
2022
entrez:
21
2
2022
Statut:
ppublish
Résumé
The link between headache and epilepsy is more prominent in patients with idiopathic/genetic epilepsy (I/GE). We aimed to investigate the prevalence of headache and to cluster patients with regard to their headache and epilepsy features. Patients aged 6-40 years, with a definite diagnosis of I/GE, were consecutively enrolled. The patients were interviewed using standardized epilepsy and headache questionnaires, and their headache characteristics were investigated by experts in headache. Demographic and clinical variables were analyzed, and patients were clustered according to their epilepsy and headache characteristics using an unsupervised K-means algorithm. Among 809 patients, 508 (62.8%) reported having any type of headache; 87.4% had interictal headache, and 41.2% had migraine. Cluster analysis revealed two distinct groups for both adults and children/adolescents. In adults, subjects having a family history of headache, ≥5 headache attacks, duration of headache ≥ 24 months, headaches lasting ≥1 h, and visual analog scale scores > 5 were grouped in one cluster, and subjects with juvenile myoclonic epilepsy (JME), myoclonic seizures, and generalized tonic-clonic seizures (GTCS) were clustered in this group (Cluster 1). Self-limited epilepsy with centrotemporal spikes and epilepsy with GTCS alone were clustered in Cluster 2 with the opposite characteristics. For children/adolescents, the same features as in adult Cluster 1 were clustered in a separate group, except for the presence of JME syndrome and GTCS alone as a seizure type. Focal seizures were clustered in another group with the opposite characteristics. In the entire group, the model revealed an additional cluster, including patients with the syndrome of GTCS alone (50.51%), with ≥5 attacks, headache lasting >4 h, and throbbing headache; 65.66% of patients had a family history of headache in this third cluster (n = 99). Patients with I/GE can be clustered into distinct groups according to headache features along with seizures. Our findings may help in management and planning for future studies.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1516-1529Informations de copyright
© 2022 International League Against Epilepsy.
Références
Whealy MA, Myburgh A, Bredesen TJ, Britton JW. Headache in epilepsy: a prospective observational study. Epilepsia Open. 2019;4(4):593-8.
World Health Organization. Epilepsy: a public health imperative: summary. World Health Organization. 2019 [cited 2022 Jan 24]. Licence:CC BY-NC-SA 30 IGO. Available from: http://apps.who.int/iris/handle/10665/325440
Mainieri G, Cevoli S, Giannini G, Zummo L, Leta C, Broli M, et al. Headache in epilepsy: prevalence and clinical features. J Headache Pain. 2015;16(1):1-10.
Syvertsen M, Helde G, Stovner LJ, Brodtkorb E. Headaches add to the burden of epilepsy. J Headache Pain. 2007;8(4):224-30.
Ertas M, Baykan B, Orhan EK, Zarifoglu M, Karli N, Saip S, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13(2):147-57.
Tonini MC, Giordano L, Atzeni L, Bogliun G, Perri G, Saracco MG, et al. Primary headache and epilepsy: a multicenter cross-sectional study. Epilepsy Behav. 2012;23(3):342-7.
Verrotti A, Coppola G, Spalice A, Di Fonzo A, Bruschi R, Tozzi E, et al. Peri-ictal and inter-ictal headache in children and adolescents with idiopathic epilepsy: a multicenter cross-sectional study. Childs Nerv Syst. 2011;27(9):1419-23.
Verrotti A, Coppola G, Di Fonzo A, Tozzi E, Spalice A, Aloisi P, et al. Should "migralepsy" be considered an obsolete concept? A multicenter retrospective clinical/EEG study and review of the literature. Epilepsy Behav. 2011;21(1):52-9.
Belcastro V, Striano P, Kasteleijn-Nolst Trenité DG, Villa MP, Parisi P. Migralepsy, hemicrania epileptica, post-ictal headache and "ictal epileptic headache": a proposal for terminology and classification revision. J Headache Pain. 2011;12(3):289-94.
Bauer PR, Tolner EA, Keezer MR, Ferrari MD, Sander JW. Headache in people with epilepsy. Nat Rev Neurol. 2021;17(9):529-44.
Parisi P, Piccioli M, Villa MP, Buttinelli C, Kasteleijn-Nolst Trenité DG. Hypothesis on neurophysiopathological mechanisms linking epilepsy and headache. Med Hypotheses. 2008;70(6):1150-4.
Parisi P. Why is migraine rarely, and not usually, the sole ictal epileptic manifestation? Seizure. 2009;18(5):309-12.
Kasteleijn-Nolst Trenité D, Parisi P. Migraine in the borderland of epilepsy: "migralepsy" an overlapping syndrome of children and adults? Epilepsia. 2012;53(suppl 7):20-5.
Parisi P, Striano P, Negro A, Martelletti P, Belcastro V. Ictal epileptic headache: an old story with courses and appeals. J Headache Pain. 2012;13(8):607-13.
Parisi P, Striano P, Verrotti A, Villa MP, Belcastro V. What have we learned about ictal epileptic headache? A review of well-documented cases. Seizure. 2013;22(4):253-8.
Belcastro V, Striano P, Parisi P. "Ictal epileptic headache": beyond the epidemiological evidence. Epilepsy Behav. 2012;25(1):9-10.
Schankin CJ, Rémi J, Klaus I, Sostak P, Reinisch VM, Noachtar S, et al. Headache in juvenile myoclonic epilepsy. J Headache Pain. 2011;12(2):227-33.
Toldo I, Perissinotto E, Menegazzo F, Boniver C, Sartori S, Salviati L, et al. Comorbidity between headache and epilepsy in a pediatric headache center. J Headache Pain. 2010;11(3):235-40.
Andermann F. Migraine and the benign partial epilepsies of childhood: evidence for an association. Epileptic Disord. 2001;2(4):37-9.
Clarke T, Baskurt Z, Strug LJ, Pal DK. Evidence of shared genetic risk factors for migraine and Rolandic epilepsy. Epilepsia. 2009;50(11):2428-33.
Winawer MR, Connors R, Investigators E. Evidence for a shared genetic susceptibility to migraine and epilepsy. Epilepsia. 2013;54(2):288-95.
Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21.
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989;30:389-99.
Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):522-30.
Statistica (data analysis software system). 13th ed. Tempe, AZ: TIBCO Software; 2018.
Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache. 2015;55(1):21-34.
Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41(7):646-57.
Wang S-J. Epidemiology of migraine and other types of headache in Asia. Curr Neurol Neurosci Rep. 2003;3(2):104-8.
Merikangas KR. Contributions of epidemiology to our understanding of migraine. Headache. 2013;53(2):230-46.
Duchaczek B, Ghaeni L, Matzen J, Holtkamp M. Interictal and periictal headache in patients with epilepsy. Eur J Neurol. 2013;20(10):1360-6.
Yamane L, Montenegro M, Guerreiro M. Comorbidity headache and epilepsy in childhood. Neuropediatrics. 2004;35(2):99-102.
Ozge A, Sasmaz T, Cakmak SE, Kaleagasi H, Siva A. Epidemiological-based childhood headache natural history study: after an interval of six years. Cephalalgia. 2010;30(6):703-12.
Mantegazza M, Cestèle S. Pathophysiological mechanisms of migraine and epilepsy: similarities and differences. Neurosci Lett. 2018;667:92-102.
Baykan B, Martínez-Juárez IE, Altindag EA, Camfield CS, Camfield PR. Lifetime prognosis of juvenile myoclonic epilepsy. Epilepsy Behav. 2013;28:S18-24.
Cvetkovska E, Panov S, Kuzmanovski I. Clinical genetic study in juvenile myoclonic epilepsy. Seizure. 2014;23(10):903-5.
Dedei Daryan M, Güveli BT, Baslo SA, Mulhan K, Sarı H, Balçık ZE, et al. Prevalence and clinical characteristics of headache in juvenile myoclonic epilepsy: experience from a tertiary epilepsy center. Neurol Sci. 2018;39(3):519-25.
Zarcone D, Corbetta S. Shared mechanisms of epilepsy, migraine and affective disorders. Neurol Sci. 2017;38(1):73-6.
Deprez L, Weckhuysen S, Peeters K, Deconinck T, Claeys KG, Claes LR, et al. Epilepsy as part of the phenotype associated with ATP1A2 mutations. Epilepsia. 2008;49(3):500-8.
Cestèle S, Labate A, Rusconi R, Tarantino P, Mumoli L, Franceschetti S, et al. Divergent effects of the T 1174S SCN1A mutation associated with seizures and hemiplegic migraine. Epilepsia. 2013;54(5):927-35.
Hasırcı Bayır BR, Tutkavul K, Eser M, Baykan B. Epilepsy in patients with familial hemiplegic migraine. Seizure. 2021;88:87-94.
Parisi P. Who's still afraid of the link between headache and epilepsy? Some reactions to and reflections on the article by Marte Helene Bjørk and co-workers. J Headache Pain. 2009;10(5):327-9.
Parisi P, Kasteleijn-Nolst Trenité DG, Piccioli M, Pelliccia A, Luchetti A, Buttinelli C, et al. A case with atypical childhood occipital epilepsy "Gastaut type": an ictal migraine manifestation with a good response to intravenous diazepam. Epilepsia. 2007;48(11):2181-6.
Thakran S, Guin D, Singh P, Singh P, Kukal S, Rawat C, et al. Genetic landscape of common epilepsies: advancing towards precision in treatment. Int J Mol Sci. 2020;21(20):7784.
Baykan B, Wolf P. Juvenile myoclonic epilepsy as a spectrum disorder: a focused review. Seizure. 2017;49:36-41.
Guaranha MS, de Araujo Filho GM, Lin K, Guilhoto LM, Caboclo LOS, Yacubian EMT. Prognosis of juvenile myoclonic epilepsy is related to endophenotypes. Seizure. 2011;20(1):42-8.
Lai K-L, Pan L-LH, Liao K-K, Chen W-T. Electrophysiological basis for antiepileptic drugs in migraine prevention. Prog Brain Res. 2020;255:69-97.
Velioğlu SK, Boz C, Özmenoğlu M. The impact of migraine on epilepsy: a prospective prognosis study. Cephalalgia. 2005;25(7):528-35.
Valeriani M, Abu-Arafeh I, Özge A. Clinical and pathophysiological peculiarities of headache in children and adolescents. Front Neurol. 2019;10:1280.
Dao JM, Qubty W. Headache diagnosis in children and adolescents. Curr Pain Headache Rep. 2018;22(3):1-6.
Jancic J, Djuric V, Hencic B, van den Anker JN, Samardzic J. Comorbidity of migraine and epilepsy in pediatrics: a review. J Child Neurol. 2018;33(12):801-8.
Ozge A, Genç H, Aksu GG, Uludüz D. Migraine and frontostriatal circuit disorders: what have we learned until now? Neurol Sci Neurophysiol. 2021;38(2):81.