Epilepsy and migraine are episodic disorders with similar clinical features and underlying pathophysiological mechanisms. While there is no evidence to suggest that migraine is the root cause of seizures or that seizures cause an individual to develop migraine, some research studies help show a connection between the two.
The connection between migraine and epilepsy
Both are chronic disorders characterized by repeated attacks of neurological dysfunction and are variously accompanied by gastrointestinal, autonomic, and other pathophysiological conditions. Epilepsy and migraines are associated by their symptoms, comorbidity, and treatment. An individual suffering from one of these diseases is twice as at risk of having the other one. However, some people with migraines develop epilepsy symptoms without another risk factor, like a stroke or head injury.
Epilepsy is a chronic neurodegenerative disorder that affects nerve cell activity in the brain and leads to recurrent seizures without a clear trigger. Because the cause of epileptic seizures is not typically apparent, doctors can’t diagnose until after an individual has had two or more seizures occurring at least 24 hours apart without a known medical cause. Different types of seizure disorders are related to epilepsy, both genetic and non-genetic. There are four types of epilepsy disorders: generalized seizure disorder, simple partial seizure, and myoclonic epilepsy. Seizures occur due to an abnormality or change in the brain or disturbed levels of nerve-signalling chemicals. They can also develop associated with another illness or infection, brain tumor, damage, or abnormal brain development.
Migraine is a neurological disorder that affects around 12 percent of the global population. The most common migraine symptom is headache, which can produce various symptoms such as nausea, light, dizziness, sensitivity, and sensory disturbances. People suffering from migraines are more likely to develop epilepsy, though they often do not develop epilepsy without another risk factor, such as head injury.
Both epilepsy and migraine may include a pre-symptom period called aura, which can happen before a migraine attack or an epileptic seizure. Aura is defined as a series of sensory disturbances such as seeing sparks, zigzags, and bright lights- numbness in one area of the body or an inability to talk.
Epilepsy doesn’t cause migraine attacks, but it can cause headaches. Known as pre-ictal headaches, these can be brief episodes of sharp, steady, or throbbing pain.
A migraine-triggered seizure is a rare complication related to migraine with aura. Also termed a migraine-aura-triggered seizure or migralepsy, this type differs from a seizure-induced migraine because it’s the migraine that brings seizure, not vice versa.
It can be tough to identify these complex events, and experts are not confident enough about the best treatment route. The goal of treatment is to reduce migraine frequency and severity, which in turn prevents migraine-induced seizures from occurring.
Symptoms and causes of epileptic migraine
The symptoms associated with migraine-triggered seizures can start with an aura, a migraine-related neurological deficit. An aura can include neurological symptoms such as visual changes, sensory changes, weakness of one side of the face or body, and trouble speaking. A patient having a migraine with aura may also experience head pain, but not always. A seizure causes diminished awareness, involuntary movements of the body, or both. As seizures affect the consciousness, it can be tough to remember every detail of migraine-induced seizure episodes. Typically, a seizure lasts minutes, while a migraine lasts for hours or days.
A migraine- aura-triggered seizure that happens due to a migraine with aura and is not noticeable in migraines without aura. According to experts, migraine aura-induced seizures develop due to certain electrical changes in the brain that come with an aura. Migraines have also been linked with an electrical pattern recognized as spreading depression, but migraines with aura include additional alterations that give rise to neurological symptoms.
It is still not understood why or how a seizure, which is related to electrical activity in the brain, occurs in the aura phase of a migraine.
There are several treatment options for preventing a neurological problem, like migraine-induced seizures, and you will need to consult a healthcare specialist if you develop this rare type of seizure. If you have these events frequently, you may also be required to follow tips for migraine prevention. Your healthcare specialist may also prescribe medicines to prevent migraine headaches and medications for epilepsy treatment.
Management is individualized, and you may need to adjust your treatment regimen over time due to the complexity of the disease.
Certain antidepressants used in migraine headache treatment can increase the risk of developing seizures in people with epilepsy. Your doctor will carefully decide on your migraine prevention program to avoid this side effect.
Several anticonvulsant drugs are used for migraine relief. Using more than one anticonvulsant can increase the risk of side effects such as fatigue and impaired coordination, so your doctor will consider these interactions when determining the medicines and doses that suit you best.
Migraine and epilepsy are both complex brain diseases. Both these conditions cause intermittent attacks and affect the way your body functions. Living with these two conditions is especially challenging. As you come across the treatment of this rare condition, try to get as much information about your symptoms as possible. Carrying a migraine diary, keeping track of your lifestyle triggers, and maintaining a consistent treatment regimen with adequate rest and self-care may help control the severity and frequency of your epilepsy migraine.