OBJECTIVE To examine the lateralizing value of unilateral peri-ictal and interictal headaches in patients with drug-resistant focal epilepsy (DRFE). METHODS Four-hundred consecutive patients undergoing presurgical evaluation for DRFE were interviewed. Patients with headache were broadly divided into two groups: peri-ictal and interictal headache. The lateralizing value of unilateral headache was compared in each group between three diagnoses: temporal lobe epilepsy (TLE), extratemporal lobe epilepsy (ETLE), and temporal-plus epilepsy (TEMP+ epilepsy). RESULTS Out of 400 patients, 169 (42.25%) had headaches. Peri-ictal headaches were experienced in 106 patients (26.5%) and interictal headaches were experienced in 63 (15.75%). In the peri-ictal group, unilateral headaches were present in 48 out of 60 patients (80%) with TLE; they were ipsilateral to the seizure focus in 45 out of 48 patients (93.75%). Unilateral headaches in patients with ETLE were present in 20 out of 31 patients (64.5%) and were ipsilateral to the seizure focus in 14 out of 20 patients (70%). In patients with TEMP + epilepsy, unilateral peri-ictal headaches were present in 9 out of 15 patients (60%); they were ipsilateral to the seizure focus in all 9 patients (100%). In the interictal headache group, unilateral headaches were ipsilateral the seizure focus in 9 out of 10 patients (90%) with TLE and 5 out of 6 patients (83.3%) with ETLE. None of the TEMP + epilepsy patients had a unilateral interictal headache. CONCLUSION Headache is a frequently encountered symptom in patients with DRFE. When occurring in a unilateral fashion, it has a high lateralizing value in temporal and extratemporal lobe epilepsies. This has been demonstrated to be true for both peri-ictal and interictal headaches. In the vast majority of patients with DRFE, unilateral headache occurs ipsilateral to the seizure focus.

中文翻译：

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耐药性局灶性癫痫发作期头痛的偏侧化价值

目的探讨单侧发作期和发作间期头痛对耐药性局灶性癫痫（DRFE）患者的偏侧化价值。方法 对 400 名接受 DRFE 术前评估的连续患者进行了访谈。头痛患者大致分为两组：发作期头痛和发作间期头痛。比较每组在三种诊断中单侧头痛的偏侧化值：颞叶癫痫（TLE）、颞叶外癫痫（ETLE）和颞加癫痫（TEMP+癫痫）。结果 在 400 名患者中，169 名 (42.25%) 有头痛。106 名患者（26.5%）经历了发作期头痛，63 名患者（15.75%）经历了发作间期头痛。在围发作期组中，60 名 TLE 患者中有 48 名 (80%) 出现单侧头痛；48 名患者中有 45 名 (93.75%) 位于癫痫病灶的同侧。31 名患者中有 20 名 (64.5%) 出现 ETLE 患者的单侧头痛，20 名患者中有 14 名 (70%) 与癫痫病灶同侧。在 TEMP + 癫痫患者中，15 名患者中有 9 名 (60%) 存在单侧发作期头痛；在所有 9 名患者（100%）中，它们都位于癫痫病灶的同侧。在发作间期头痛组中，10 名 TLE 患者中有 9 名 (90%) 和 6 名 ETLE 患者中有 5 名 (83.3%) 的单侧头痛是癫痫发作的同侧病灶。TEMP + 癫痫患者均未出现单侧发作间期头痛。结论 头痛是 DRFE 患者的常见症状。当以单边方式发生时，它在颞叶和颞叶外癫痫中具有很高的偏侧化价值。这已被证明适用于发作期和发作间期头痛。在绝大多数 DRFE 患者中，单侧头痛发生在癫痫病灶的同侧。