Headaches provoked by cortical stimulation: Their localizing value in focal epileptic seizures.

Epilepsy Behav

Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, Lyon, France; Department of Neurology Neurological Hospital, Hospices Civils de Lyon and University of Lyon, France. Electronic address:

Published: September 2021

AI Article Synopsis

  • The study looked at whether electrical brain stimulations during epilepsy tests can cause headaches in patients.
  • They found that headaches happened in 1.3% of the tests, usually felt on both sides of the head.
  • Headaches were more common when stimulating certain brain areas, especially in the temporo-frontal limbic regions, suggesting these areas might be linked to triggering headaches during seizures.

Article Abstract

Objective: Electrical stimulations performed in awake patients identified dura mater, venous sinuses, and arteries as pain-sensitive intracranial structures. However, cephalic pain has been only occasionally reported in patients with epilepsy undergoing stereo-electroencephalography (SEEG) stimulations.

Methods: The aim of our study was to investigate whether headache can be triggered by SEEG stimulations and might be related to specific cortical areas. Data were gathered from 16 050 stimulations collected in 266 patients who underwent a SEEG as part of a presurgical assessment of their drug-resistant epilepsy.

Results: Two-hundred and eight stimulations (1.3%) evoked headaches. Pain was more frequently described as bilateral (42.31%) than ipsilateral (16.83%) or contralateral (14.42%) to the stimulated hemisphere. Headache was more frequently elicited during stimulation of the insulo-limbic regions such as the anterior and medial cingulate gyrus, the mesial part of temporal lobe, and the insula.

Conclusion: This study shows that cortical stimulation can evoke headache, mostly during stimulation of the temporo-frontal limbic regions. It suggests that brief epileptic headache can be an epileptic symptom caused by a cortical discharge involving somatic or visceral network and does not reflect only trigemino-vascular activation. Although not specific, the occurrence of a brief epileptic headache may point to a seizure origin in the temporo-frontal limbic regions.

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Source
http://dx.doi.org/10.1016/j.yebeh.2021.108125DOI Listing

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