Ice pick headache and electrical seizures: a unique clinical entity?

Headache is often ignored as a symptom of epileptic seizure. To date, there have been no reports of ice pick headache as a symptom or association in epileptic seizure. Six children (ages 5.5-10 years; average 8.6 years; male-female ratio, 2:1) presenting with ice pick headache and paroxysmal electroencephalographic changes compatible with the diagnosis of epilepsy were evaluated. Only 66.6% had clinical seizures. The antiepileptic drugs were consistently effective in all cases. These findings seem to suggest that a distinct group of symptoms and signs (ice-pick headache, paroxysmal electroencephalographic changes, and epileptic seizure), which, associated together form a characteristic clinical picture or entity. This is the first report, to date. This report highlights the necessity to further search this unique clinical condition.