Short-Lasting Retroorbital Pain Attacks as a Form of Ictal Epileptic Headache

The authors report a case of frontal lobe epilepsy manifesting as severe retro-orbital headache. The patient had a history of epilepsy and refractory periorbital and facial pain occurring from sleep. Workup demonstrated focal cortical dysplasia in the right frontal lobe and right parietal cortex. Scalp EEG was negative, but subdural electrodes captured the epileptic event arising from the right frontal lesion. Resection completely relieved the headaches.

This case demonstrates the importance of recognizing atypical features of ictal epileptic headaches.

– Kyle Binder, MD

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