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Are Migraines And Seizures Linked

Defining Epilepsy And Migraines

Migraines and Epilepsy Linked
  • Epilepsy can be defined as: A chronic noncommunicable disease of the brain that is characterized by recurrent seizures.

Epileptic seizures involve a sudden burst of electrical activity in the brain which may cause certain behavior or bodily movements. They usually last between a few seconds and a couple of minutes.

  • Migraine can be defined as: An inherited tendency to have headaches with sensory disturbance.

Migraines are very severe headaches which normally stop the sufferer from doing their usual activities. They often last several hours . People often get them once every few months but sometimes more frequently.

Can migraine cause seizures then? There is no definite evidence that migraines cause seizures. However, some researchers theorize that migraines may cause damage to the brain, and this could be a cause of seizures.

A Case Study On Migraines And Seizures

A 21-year-old female was seen by a neurologist, Dr. Mark Green, because of headaches and convulsions. She had migraines with light and sound sensitivity and nausea about 3 times a month. However, 3 to 4 times a year she had an episode where she would feel ill and then wake up on the floor. Witnesses described her as going through convulsions. After this occurred, she would get a throbbing headache and nausea but did not have light and sound sensitivity. This lasted until she went to sleep at night. She reported seeing some zigzag lines on the right side of her vision, lasting about 10 minutes with a headache just before. During her menstruation, she experiences both seizures and migraines more often.

The zigzag lines she is seeing follow the pattern for an aura before a migraine. Many of those with epilepsy have auras as well. However, the latter often have a rising feeling in the chest, but visual disturbances can occur too. Its hard to know if the aura is the warning sign of a migraine or a seizure. Many seizures are followed by migraines.

Current research shows that the cortex of the brain in those with migraines is hyper-excitable, making them more sensitive to triggers that do not bother others, such as drinking wine, hormone cycles, and weather changes. When we consider this, it makes sense then that epilepsy occurs in people with migraines as this too is similar to an electrical storm in the cortex of the brain.

How Is Epilepsy Related To Migraines

Migraines and epilepsy are both neurological disorders more than that, doctors have noticed an unusually high incidence of epileptic episodes in people who get migraines with aura, attributing the correlation to genetics.

In a recent study which focused on 730 patients with epilepsy, migraine with aura symptoms were prevalent among people who inherited epilepsy from other family members.

Moreover, the study found that epileptic patients who had at least three close relatives with epilepsy were twice as likely to suffer from migraines with aura as epileptics with fewer links to hereditary epilepsy, suggesting a higher-than-normal risk for migraines with aura if you have a family history for epileptic seizures.

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Migraine And Dementia: Are They Linked

  • Alzheimers disease is the sixth-leading cause of death for adults in the United States.
  • Now a new study finds that one risk factor of dementia is migraine.
  • But experts point out even people with chronic migraine can take steps to decrease their risk for dementia.

Migraine attacks are a problem for millions of Americans each year, but the long-term impact of this sometimes debilitating condition has been unclear.

Now a new study published in the International Journal of Geriatric Psychiatry suggests that migraine, the most common neurological disorder across all ages, is an important risk factor of dementia, especially Alzheimers disease.

Alzheimers disease is the sixth-leading cause of death among all U.S. adults and the fifth-leading cause for people ages 65 or older, according to the Centers for Disease Control and Prevention . Theres no current cure for this degenerative neurological condition.

Suzanne L. Tyas, PhD, from the University of Waterloo in Ontario, Canada, and senior author of the study, told Healthline that this early research may help experts better predict whos at risk for this disease.

Our results show that we should be paying attention to migraines in Alzheimers disease, and that this future research is warranted to fully understand what it is about migraines that affect Alzheimers disease, and how we can mitigate this risk, Tyas said.

After tracking them for 5 years, they found 51 of them had developed dementia.

Symptoms Of Migraine And Seizure

Chronic Migraines and Seizures Linked

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 .

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 ictal epileptic headache , and it can last from seconds to days.

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
  • nausea
  • vomiting
  • light and sound sensitivity

Having both disorders is called comorbidity. Its 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. Researchers are studying genetic mutations common to both seizures and migraine.

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.

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Features That Characterize Episodic Disorders

In addition to both being members of the family of episodic disorders and often existing together in the same individual, epilepsy and migraine have other similarities. Seizures and migraine attacks may evolve in four comparable stages, with prodromal symptoms, an aura, an ictus and a postdromal or postictal phase. Occasionally, the attacks fail to stop, resulting in status epilepticus or status migrainosus. Although there may be a greater diversity of trigger factors for migraine than for epilepsy, there are a surprisingly large number of similar triggers such as stress , factors related to sleep, photic stimulation, hormonal changes such as those occurring during menstruation, and alcohol or dietary factors. How these factors bring on a migraine attack or epileptic seizures is not well understood. However, there is evidence for enhanced cortical responsiveness to diverse stimuli in migraine as well as in epilepsy as discussed later in this chapter.

Migraine And Epilepsy Connection

Right now, researchers are not sure if there is a migraine and epilepsy connection. However, one study did find that people whose close family have epilepsy are more likely to suffer from migraines. This suggests there could be a genetic link, but more research is needed.

There are also certain similarities between epilepsy and migraine headaches:

  • Similar triggers

Epileptic seizures and migraine headaches can both be triggered by things like stress, alcohol and lack of sleep.

  • Similar treatments

There are certain kinds of migraine and seizure medication which are used to treat both conditions, such as topiramate

  • Similar symptoms

Migraine and epilepsy share some symptoms, including headaches, numbness in the arms and face, and feeling sick

Both conditions sometimes cause people to have an âauraâ which is an unusual visual or physical sensation which tells them a seizure or a migraine might happen soon.

While these similarities are important, it is also crucial to remember that migraine and epilepsy are different in important ways. Migraine affects a far higher number of people than epilepsy, it is much more common in women and seizures can be life-threatening in a way that a migraine is not.

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Underlying Mechanisms For The Overlap Between Headache Epilepsy And Photosensitivity

From both a genetic and clinical point of view, the concept of a continuum, or maybe even a complete overlap, between headache and epilepsy is gaining increasingly strong evidence-based support. Indeed, a novel SCN1A L263V mutation in a family with co-segregating hemiplegic migraine and epilepsy and a Na+, K+-ATPase pump defect have been documented. Moreover, up to 75% of FHM families have a mutation in the P/Q-type calcium channel Ca2.1 subunit CACNA1A gene on chromosome 19p13, while a candidate region of 9.95 cM between markers GATA152H04 and D9S253 located at chromosome 9q21q22 was identified in a large Belgian family with occipitotemporal lobe epilepsy associated with migraine with visual aura .

It should be stressed that, as occurs for autonomic manifestations , children are far more likely to develop migraine as the sole epileptic manifestation than adults. A clinical observation is also that during extensive photic stimulation, especially children with generalized PPRs complain of headache. Why the occipital lobe stimulates autonomic symptoms and signs to a much greater extent than other cortical areas is still unknown. Although a correlation between the microstructure and function of an area and its connections has been established for many cortical regions, particularly for primary sensory and motor areas , very little is as yet known about the anatomofunctional pathways linking the cerebral cortex and cortico-subcortical vegetative/autonomic neural networks.

How Ms And Migraine Are Considered To Be Alike

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MS and migraine have some similarities, including:

  • They’re both chronic and consist of attacks followed by periods of remission. The majority of patients with multiple sclerosis have a form of the disease called relapsing-remitting MS, which means their disease is characterized by episodes of neurological symptoms and/or disability, known as relapses. And, of course, many with migraines also experience them off and on for extended durations. However, the duration of the neurological symptoms is quite different between these two conditions, lasting usually less than one hour in migraine patients and a couple of weeks, on average, with an MS relapse.
  • They can involve visual symptoms. Certain MS symptoms, for example, optic neuritis, can sometimes be difficult to distinguish from those of a migraine attack, especially migraine with aura, in which visual symptoms commonly occur. Fortunately, the duration of the visual symptoms as well as their characteristics help differentiate both conditions.
  • They both have triggers that can contribute to attacks. Like those with migraine, people with MS often report triggers for their relapses or attacks, especially stress.
  • They affect individuals differently. While people with MS have different levels of disability and rates of progression of their disease, migraineurs often describe unique triggers and symptoms associated with their attacks. In other words, the experience of either issue varies greatly from person to person.

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What Is A Migraine

A migraine is a type of headache with symptoms like a severe and throbbing headache on one side of the head accompanied by nausea, vomiting, dizziness, visual disturbances, numbness or tingling in the extremities or face, sensitivity to light and sound, touch and smell.

Some people with migraines experience an aura before the head pain starts. Migraine aura symptoms include visual disturbances ocular migraine), water retention, problems sleeping, appetite changes, and irritability.

Migraine And Epilepsy Are Highly Comorbid

Individuals with one disorder are at least twice as likely to have the other.1,47 Comorbid disease presents challenges in both differential diagnosis and concomitant diagnosis.8 When diseases are comorbid, the principle of diagnostic parsimony does not apply. Individuals with one disorder are more likely, not less likely, to have the other.

In the Epilepsy Family Study, among probands with epilepsy who were classified as having migraine on the basis of their self-reported symptoms, only 44% reported physician-diagnosed migraine.91 In the general population, 29% of men and 40% of women with migraine reported a medical diagnosis.12 The proportion of probands reporting a physicians diagnosis of migraine was surprisingly low, given that all were already being treated for epilepsy.

Why is the comorbidity of migraine and epilepsy not recognized? Epilepsy may be viewed as a more serious disorder than migraine. As a result, the migrainous symptoms of patients with a diagnosis of epilepsy may have been overlooked or attributed to the seizure disorder.

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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 cant be made with certainty, especially in people with a history of both migraine and seizures. An electroencephalogram can help, but an EEG isnt often prescribed in these circumstances.

Migraine seizures usually include symptoms such as:

What To Do For Vertigo And Migraines

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If it turns out your vertigo is connected to migraines, dont panic. Since these conditions can both be related to a misalignment of the top bones of the spine, there may be a simple way to reduce the frequency and severity of attacks.

Have you experienced a head or neck trauma, even one several years in the past that you thought was completely healed? If an underlying misalignment went unnoticed in the top two bones of the spine, the following might have resulted:

  • Inhibited Brainstem Function The brainstem is protected by the C1 . If this bone becomes misaligned, it can put pressure on the brainstem. This, in turn, can create the conditions for migraines and vertigo.
  • Restricted Blood Flow to the Brain The cervical vertebrae have tiny loops of bone called vertebral foramen. These provide a safe path for the arteries that bring blood to the brain. Unfortunately, a misalignment can create a kink in the line. If this is restricting blood flow to certain parts of the brain, vertigo and migraines are just a couple of possible results.
  • Inhibited Cerebrospinal Fluid Drainage When the top two bones of the neck are misaligned, it can affect cerebrospinal fluid drainage. This can lead to intracranial pressure and, once again, migraines and vertigo.

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The Problem Of Misdiagnosis

Studies have found that migraines occur two to three times more often in people with MS than in the general population. In addition, some symptoms of migraine and MS can be similar, reinforcing the importance of reporting the duration and quality of your symptoms to your healthcare provider in detail.

Due to these potential similarities, a person having migraines may be misdiagnosed with MS. A 2016 study performed at four academic MS centers looked at records of 110 patients who had been misdiagnosed with MS, some believing they had MS for 20 years or more. The most frequent alternate/correct diagnosis was migraine, either alone or in combination with other diagnoses, which was found in 22 percent of the misdiagnosed patients.

Not only are there overlapping symptoms between the two, but both migraine and MS can show abnormalities in your brain as well. When you see a neurologist for your headaches, you’ll typically have magnetic resonance imaging of your brain. If you have migraine or MS, it may show brain lesions called white matter lesions or T2 hyperintensities, although the pattern is usually different in each. This is why these lesions need to be interpreted carefully on an MRI and considered along with your symptoms.

Epilepsy Migraines And Genes

When researchers studied about 500 families that included two or more members with epilepsy, they found that people with the largest number of close relatives with seizures also had the highest migraine risk.

Those with three or more close relatives with seizure disorder had more than double the risk for migraine with auraheadaches with additional symptoms such as nausea or sensitivity to sound or light.

âThere are many reasons two diseases occur together, but it has not really been clear until now that these two diseases are genetically linked,â she says.

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Can Migraine Cause Seizures

Researchers havent found any evidence of a causal connection between migraine and seizures indicating that migraine causes seizures, or that seizures cause migraine.

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.
  • Gene mutations might make people more susceptible to both disorders.

If you have epilepsy, its possible that you experience both migraine and non-migraine headaches. Its 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.

  • before seizure episodes


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