Children and adolescents have migraine, too. Around
People with active epilepsy are especially prone to migraine. They’re
The relationship between epilepsy and migraine has been known since the beginning of the last century, when William R. Gowers first wrote about it in 1907.
Researchers still haven’t entirely deciphered that connection. They currently think it stems from shared genetic or environmental factors, which then lead to temporarily altered brain function.
Research does show that the two conditions are often comorbid, meaning they both occur in one person. Also, people with epilepsy are more prone to have migraine, and people with migraine are more prone to have seizures.
The reasons for this increased susceptibility to both disorders has yet to be determined. Possibilities include:
- Migraine attacks may trigger a seizure. This is considered a rare complication of a migraine with aura, which is also called a migraine aura-triggered seizure.
- Symptoms of migraine might trigger a seizure. For example, the flashing lights of a migraine aura might bring on a seizure.
- Seizures might cause brain abnormalities. Since both migraine and seizures involve abnormal brain activity, it may be that chronic seizures could pave the way for migraine attacks.
- Shared genetics may play a part. Gene mutations might make people more susceptible to both disorders.
If you have epilepsy, it’s possible that you experience both migraine and non-migraine headaches. It’s also possible that either a migraine attack or another type of headache may occur before, during, or after your seizure.
Because of these varied scenarios, your doctor will need to consider your symptoms carefully to determine whether your migraine and seizure are related.
To analyze any possible connection, doctors look carefully at the timing of a migraine attack to note whether it appears:
- before seizure episodes
- during seizure episodes
- after seizure episodes
- between seizure episodes
Drugs used to treat seizures, called anti-epileptic drugs (AEDs), can be effective for the prevention of migraine as well. Your doctor’s choice of which one to prescribe for you will depend on your:
- possibility of pregnancy
- type and frequency of your seizures
Several types of medications are used for the prevention and treatment of migraine, including:
If your migraine attacks persist, your doctor may prescribe other medications.
Whatever regimen you and your doctor choose, it’s important for you to know how to navigate a medication program and to understand what to expect. You should do the following:
- Take medications exactly as prescribed.
- Expect to start with a low dose and increase gradually until the drug is effective.
- Understand that symptoms probably won’t be eliminated altogether.
- Wait for 4 to 8 weeks for any significant benefit to occur.
- Monitor the benefit that appears in the first 2 months. If a preventive drug provides marked relief, the improvement may continue to increase.
- Keep a diary that documents your medication use, pattern of symptoms, and the impact of the pain.
- If the treatment is successful for 6 to 12 months, your doctor may recommend gradually discontinuing the medication.
On the surface, the symptoms of a migraine attack and a seizure may not seem to resemble each other very much.
But a variety of symptoms are common to both disorders. Both are episodic conditions, meaning they occur as episodes with a beginning and an end, within otherwise normal periods of time.
Probably the most common shared symptom is a headache. Migraine with aura is one of three types of headaches associated with epilepsy in the International Classification of Headache Disorders (ICHD).
Headaches can occur both before, during, or after a seizure. Sometimes a headache is the only symptom of a seizure. This type of headache is called an
Epilepsy and migraine often share other symptoms, especially in the aura that precedes either a migraine attack or a seizure. These shared symptoms can include:
- flashing lights and other visual distortions
- light and sound sensitivity
Having both disorders is called comorbidity. It’s thought to occur because both epilepsy and migraine are episodic disorders associated with electrical disturbances in the brain.
There are also apparent genetic links between the two disorders.
By further genetic analysis, scientists hope to better define the genetic association of migraine and epilepsy and be able to identify their exact causes and effective treatments.
The connection between seizures and migraine can depend on the specific type of migraine that you have. Read on to learn how seizures may relate to the various types of migraine.
Migraine with brainstem aura and seizures
It’s different from a seizure-induced migraine. In that case, it’s the seizure that causes migraine, not the other way around.
Vestibular migraine and seizures
Vertigo is most commonly caused by migraine and inner ear issues. However, vertigo has also been very rarely associated with epilepsy.
Because of this mild association of epilepsy with vertigo, seizures are sometimes confused with vestibular migraine, whose main symptom is vertigo.
Vestibular migraine is thought to be the most common cause of vertigo. But vestibular migraine doesn’t occur as part of a seizure, nor does a seizure occur as part of a vestibular migraine.
The only link between vestibular migraine and seizures is the shared symptom of vertigo.
Vestibular migraine won’t bring on a seizure, and a seizure won’t bring on a vestibular migraine attack.
The type of migraine that may trigger a seizure, though rarely, is migraine with aura, not vestibular migraine.
Visual migraine and seizures
Visual migraine comes in three types:
- Migraine with aura but without pain. These have visual aura, often appearing as zigzags or other forms in your vision, and last less than 1 hour. No headache follows.
- Migraine with aura. These headaches also involve visual aura, but a headache follows. It can last from several hours to days.
- Retinal migraine. This is the rarest form of ocular migraine. Its distinguishing characteristic is that the visual aura appears in only one eye instead of both eyes as in other ocular migraine episodes.
Migraine aura symptoms may act as triggers for epileptic seizures. However, this is considered a rare occurrence. Migraine-induced seizures are brought on by migraine with aura, not by migraine without aura attacks.
Diagnosing a migraine-induced seizure is complex because a diagnosis requires evidence that the aura or headache triggered the seizure, instead of being simply part of the aura symptoms that preceded the seizure.
Also, since a seizure can sometimes trigger a migraine with aura attack, a migraine-induced seizure diagnosis requires that the doctor determine which came first: the migraine attack or the seizure.
These distinctions often can’t be made with certainty, especially in people with a history of both migraine and seizures. An electroencephalogram (EEG) can help, but an EEG isn’t often prescribed in these circumstances.
Migraine seizures usually include symptoms such as:
- weakness on one side of the body
- difficulty speaking
- involuntary movements
- diminished consciousness
A migraine seizure usually lasts only several minutes, while the migraine attack may continue for hours, or even several days.
Hemiplegic migraine and seizures
Hemiplegic migraine affects one side of the body. You feel a temporary weakness on that side of your body, often in the face, arm, or leg. Sometimes there’s also paralysis, numbness, or a pins-and-needles sensation.
The weakness usually lasts only about 1 hour, but it may continue for several days. A severe headache usually follows the weakness. Sometimes the headache comes before the weakness and occasionally there’s no headache at all.
Hemiplegic migraine is considered a type of migraine with aura. It’s therefore associated with epilepsy, and a person can have both this type of migraine and seizures.
Heredity definitely plays a part in the relationship between seizures and migraine. Both disorders are thought to be hereditable conditions, and genetic similarities may help explain why both disorders sometimes occur within the same family.
Four of the same genes often have one or more mutations in people with either disorder. These genes are CACNA1A, ATP1A2, SCN1A, and PRRT2.
The clearest genetic connection appears to be the SCN1A gene mutation, which is associated with hemiplegic migraine and
There are two types of hemiplegic migraine: familial and sporadic. A familial type is diagnosed if two or more people in one family have this type of migraine, while a sporadic diagnosis applies when only one person does.
Headaches, and migraine attacks in particular, are also more common among people with epilepsy than among the general population. Research estimates
Researchers also think genetics may increase a person’s likelihood of developing both seizures and migraine. Research shows that having close relatives with epilepsy substantially increases your chances of having a migraine with aura.
Other factors that may increase your likelihood of having both migraine and seizures include the use of antiepileptic drugs and being overweight or obese.
The good news is that you may be able to avoid migraine pain. Prevention strategies are recommended if your migraine pain is frequent or severe and if every month, you have one of the following:
- an attack on at least 6 days
- an attack that impairs you on at least 4 days
- an attack that severely impairs you for at least 3 days
You might be a candidate for prevention for less severe migraine pain if every month you have one of the following:
- an attack for 4 or 5 days
- an attack that impairs you on at least 3 days
- an attack that severely impairs you for at least 2 days
There are several lifestyle habits that may increase the frequency of attacks. To help avoid migraine attacks, consider doing the following:
- avoid skipping meals
- eat meals regularly
- establish a regular sleep schedule
- make sure you get enough sleep
- take steps to avoid too much stress
- limit your caffeine intake
- make sure that you get enough exercise
- lose weight if your doctor recommends it
There’s no one strategy that’s the best for preventing migraine attacks. Trial and error is a reasonable approach for you and your doctor in the search for your best treatment option.
Migraine pain is most common in early and middle adulthood and can decline in later life. Both migraine and seizures can take a high toll on a person.
Researchers continue to examine migraine and seizures both alone and together. Promising research is focused on diagnosis, treatment, and how genetic background might contribute to understanding these conditions.