Most patients with epilepsy also suffer from headaches. Headaches are common mostly after tonic-clonic seizures, but can also follow simple and complex partial seizures. These headaches are called post-ictal headaches because they occur after seizure activity. Post-ictal headaches are usually generalized, steady/throbbing with a duration from 6 – 24 hours and can be very disabling resulting in loss of time from routine activities.

Though less common, a headache may also occur before a seizure. A headache is sometimes the only symptom of a seizure and is a type of aura as it warns of a coming seizure. These headaches are called pre-ictal headaches, because they occur before the start of any seizure activity. These headaches are usually short-lasting with a throbbing, steady or sharp quality.

A headache can also occur during a seizure episode. This is very rare, but are actually seizure symptoms. Can be pounding, but also sharp and steady. Onset can be sudden or pain can just build gradually. Ictal headaches are seen in all types of epilepsy.

Patients with seizures are twice as likely to have migraine headaches. Migraines and seizures have very common symptoms. They can both be triggered by the same things such as stress, alcohol, hormones, fatigue, dehydration. Also, the aura before a migraine is very similar to the aura before a seizure which may consists of flashing lights, zig-zag lines, distorted images, blind spots, etc.

Don’t be afraid to seek medical treatment if you have both headaches and seizures.

Tanesha Reynolds, DNP, FNP-BC