Background: Migraine pathophysiology has been linked to neuroinflammation. During a migraine attack, trigeminal activation results in the release of calcitonin gene-related peptide (CGRP), which stimulates the release of inflammatory cytokines and plays an important role in migraine, primary headache disorders, and possibly epilepsy. This is the first study at Zagazig University Hospitals to assess the role of CGRP in primary headache among epileptic patients.

Aim: To investigate the different types of primary headache disorders among epileptic patients to find out the clinical correlation between serum CGRP level and severity and type of headache among these patients which can reflect management strategy for better management options of this common comorbidiy.

Methods: This study was conducted at Neurology Department and Outpatients Epilepsy and Headache Clinics, Faculty of Medicine, Zagazig university on 69 patients with epilepsy who were divided into two groups: group (1): 46 Epileptic patients suffering from primary headache disorder and group (2): 23 Epileptic patients without headache. Level of Calcitonin Gene Related Peptide was measured.

Results: CGRP was significantly higher in epileptic patients with headache than those without headache. CGRP expression ≥61: shows sensitivity 75%, specificity 83.3% and accuracy 78.3% to discriminate epileptic patients with migraine headache from epileptic patients with tension headache.

Conclusion: The serum CGRP levels were significantly more in migraine patients and was correlated with characteristics like throbbing type of pain, stress and inadequate sleep.