Epileptic seizure during the aspirin and caffeine withdrawal in a drug induced headache

A 45-year-old female migraineur with a long-standing history of drug-induced headache is described. She had been abusing caffeine (250 mg/day) and aspirin (5 gr/day). On the third day after discontinuation a withdrawal syndrome characterized by headache and a generalized tonic-clonic seizure occurred. The temporal association makes it likely that the convulsion episode in an integral component of the withdrawal syndrome in this patient. This extra feature of the withdrawal syndrome has never been described after caffeine and/or aspirin interruption. Possible pathogenetic mechanisms are discussed.