People with epilepsy may experience headaches before or after a seizure. Rarely, they may also get them as a seizure symptom.

Epilepsy and headaches may share similar features, including genetic factors, atypical brain activity, and triggers.

Treatments for epilepsy and headache may also be similar and can help people manage both conditions.

This article looks at the link between headaches, migraine, and epilepsy. It will also explore treatment and prevention options for them.

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According to the Epilepsy Foundation, people with epilepsy are more likely to experience headaches than those without the condition and may be twice as likely to experience migraine.

Individuals may experience a headache before or after a seizure. Headaches commonly occur after a tonic-clonic seizure and can also happen after simple and complex partial seizures.

If people feel stress or anxiety around managing epilepsy or seizures, they may also develop tension, leading to tension headaches.

Both epilepsy and headaches may share similar mechanisms and genetic factors, although researchers are still unclear on the exact link between them.

Certain medications may help prevent headaches in people with epilepsy. Taking daily medication may prevent headaches from occurring.

The first-line medication for preventing headaches and seizures is usually valproate. Other medications that may help prevent headaches include:

Treatment will depend on the type of headaches a person experiences. For example, doctors may recommend verapamil for cluster headaches and topiramate to prevent migraine and seizures.

If people have headaches as a seizure symptom, called ictal headaches, seizure medication may prevent headaches if it can control the atypical brain activity that occurs with epilepsy.

People can treat headaches with over-the-counter (OTC) pain relief medication, such as:

If a person’s pain does not reduce with OTC pain relief, a doctor may prescribe a stronger medication, such as naproxen.

A person can contact a doctor if they have headaches with epilepsy. A doctor will help people create a treatment plan for both conditions, which may help control or prevent headaches and seizures.

People may find it helpful to track their symptoms regarding epilepsy, headache, and any side effects of medication. If they have any unexpected changes or concerns in symptoms, they can discuss them with a doctor.

Seizures are not usually an emergency, but people will need to call 911 if any of the following occur:

  • this is the first seizure a person has had
  • the person has difficulty breathing or waking after a seizure
  • the person has an injury during a seizure
  • a seizure lasts for more than 5 minutes
  • a second seizure occurs shortly after the first seizure
  • a seizure takes place in water
  • the person has a seizure and is pregnant or has a chronic health condition, such as diabetes or heart disease

People will need to contact a doctor straight away if they have a headache with any of the following:

  • a sudden, severe headache with a stiff neck
  • a severe headache with fever, vomiting, or nausea with no known cause
  • a headache with confusion, weakness, double vision, or loss of consciousness
  • a headache that worsens over the course of days or weeks, or changes in pattern or symptoms
  • a headache after a head injury
  • a headache with weakness or a loss of sensation, which may indicate a stroke
  • a headache with shortness of breath or convulsions
  • two or more headaches per week
  • experiencing new headaches with a history of cancer, HIV, or AIDS
  • new, persistent headaches, especially if over the age of 50 years

This section answers some frequently asked questions about headaches and epilepsy.

Can epilepsy cause headaches?

Migraine and epilepsy have strong links. They can both result from variations in atypical electrical activity in the brain, and it is possible for migraine to trigger a seizure and vice versa.

People with epilepsy may experience headaches as a symptom before or after a seizure. In rare cases, a headache may be a seizure symptom.

What do epilepsy headaches feel like?

The most common type of headache that occurs with epilepsy is a postictal headache. These occur after a seizure, and people may experience the following:

  • widespread headache pain
  • steady or throbbing pain
  • mild or severe intensity
  • disabling pain that prevents people from carrying out everyday activities

This type of headache may last between 6 and 24 hours or longer.

Is there a link between epilepsy and migraine?

Both epilepsy and migraine may share similar features, such as genetic factors, and both conditions occur from atypical brain activity. Certain medications may also help treat both conditions.

According to the Epilepsy Foundation, people with migraine may experience an aura similar to one that occurs before a seizure. An aura occurs before roughly 30% of migraine attacks.

Migraine and seizures may also share similar triggers, such as stress, fatigue, alcohol, and menstruation.

People with migraine also have an increased risk of epilepsy, although this usually does not occur without having an additional risk factor, such as a head injury. There is no strong evidence to suggest migraine causes seizures.

People with epilepsy may have an increased risk of headaches. A headache may occur after a seizure or sometimes before. In rare cases, a headache may be a seizure symptom.

Although researchers are unsure of the exact link between epilepsy and headaches, similarities include genetic predisposition, atypical brain activity, and mechanisms of action.

Certain medications may help control or prevent both seizures and headaches.