7.6.1 Ictal epileptic headache

Previously used term:

Ictal headache.


Headache caused by and occurring during a partial epileptic seizure, ipsilateral to the epileptic discharge, and remitting immediately or soon after the seizure has terminated.

Diagnostic criteria:
  1. Any headache fulfilling criterion C
  2. The patient is having a partial epileptic seizure
  3. Evidence of causation demonstrated by both of the following:
    1. headache has developed simultaneously with onset of the partial seizure
    2. either or both of the following:
      • a) headache is ipsilateral to the ictal discharge
      • b) headache significantly improves or remits immediately after the partial seizure has terminated
  4. Not better accounted for by another ICHD-3 diagnosis.

7.6.1 Ictal epileptic headache may be followed by other epileptic manifestations (motor, sensory or autonomic).

This condition should be differentiated from ‘‘pure’’ or ‘‘isolated’’ ictal epileptic headache occurring as the sole epileptic manifestation and requiring differential diagnosis from other headache types.

‘‘Hemicrania epileptica’’ (if confirmed to exist) is a very rare variant of 7.6.1 Ictal epileptic headache characterized by ipsilateral location of headache and ictal EEG paroxysms.