Migraine and epilepsy

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By Wei-Ta Chen MD

The association between migraine and epilepsy was established more than a century ago. Both disorders are inter-related in epidemiological, clinical, and genetic studies. Although the pathophysiology underpinning such link remains unknown, there has been increasing evidence for a shared genetic susceptibility to migraine and epilepsy that may alter central excitability in both disorders. A recent neurophysiological study using transcranial magnetic stimulation showed a common feature of cortical excitability changes in migraine and epilepsy. Dr. Chen of Taipei Veterans General Hospital in Taipei, Taiwan, explains the details.

Key Points

  • Migraine and epilepsy are nosologically similar and both encompass 4 phases in their attacks: premonitory, aura, ictal, and resolution.
  • Migraine and epilepsy are clinically related disorders because migraine may follow (postictal migraine) or trigger (migralepsy) seizure attacks.
  • Migraine and epilepsy are epidemiologically interrelated because patients with migraine have a higher chance of also having epilepsy.
  • Recent data suggest the comorbidity of migraine and epilepsy may have shared genetic links altering cerebral excitability.
  • Anticonvulsants are the choice of treatments for comorbid migraine and epilepsy.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited