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Are Migraines And Seizures Related

How Seizures Differ From Migraines

Health Chat: Headaches, Migraines and Seizures

Seizures arise from brain damage, though the causes can range from a severe head trauma to high fever. Someone with seizures will develop the condition after the brain damage.

When someone has a seizure, headaches will often occur after the seizure has occurred. With migraines, the symptoms like confusion and visual auras will start shortly before or in conjunction with the headache.

The biggest differentiation between seizures and migraines is in brain activity. An EEG for someone suffering a seizure will show sharp waves and spikes, something not seen when you have a migraine headache.

Symptoms Of Migraine And Seizure

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.

Migraines And Seizures: Understanding The Link

If youre affected by migraine pain, youre not alone. About 11 percent of adults worldwide live with migraine.

Children and adolescents have migraine, too. Around 8 percent of people under 20 years old have experienced migraine over at least a 3-month period.

People with active epilepsy are especially prone to migraine. Theyre twice as likely as the general population to have migraine.

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 havent entirely deciphered that connection. They currently think it stems from shared genetic or environmental factors, which then lead to temporarily altered brain function.

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:

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.

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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.

Epilepsy And Migraine: A Common Ground

Migraine and Epilepsy: Is There a Genetic Link Between the ...

    Migraine and epilepsy have several things in common: they often co-occur and share similar symptoms, each is generally undertreated, one is often misdiagnosed as the other,1 and various medications are effective in treating both disorders.2 Recent research may help elucidate the relationship between the two and shed light on more appropriate diagnosis and treatment options.

    Patients with migraine are more likely to have epilepsy, and patients with epilepsy are more likely to experience migraine, Pavel Klein, MD, director of the Mid-Atlantic Epilepsy and Sleep Center, told Neurology Advisor. In fact, people with seizure disorders are twice as likely to experience migraines which can often lead to misdiagnosis.3

    There are commonalities between the two disorders in clinical symptomatology, particularly with regard to visual and other sensory disturbances, pain, and alterations of consciousness.3 For instance, if a patient has a migraine that causes focal neurological symptoms numbness in the arm or face, for example it can appear to be a seizure. It is also known that stress can trigger seizures, and in a less common scenario, in someone with very severe migraine, it is possible that the stress of the pain could trigger a seizure, Klein explained.

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    A Thorough Upper Neck Evaluation

    After a postural and x-ray evaluation, it was determined that her atlas was out of alignment. After her initial adjustment her walking had improved as well as her neck range of motion specifically rotation, which had been severely decreased for years. The patient reported an increase in energy.

    The patients care was continued. During each visit, she was checked to make sure the adjustment was holding through subjective evaluation, scanning palpation, and supine leg check. Further visits saw improvement in her walking including the ability to walk heel-to-toe. Her balance improved to where she could stand on one foot. She noticed a general improvement in her vision specifically clarity, brightness, and color perception are her lazy eye diminished and then finally went away. Finally, it should be noted that she had not had a seizure with the accompanying migraine since beginning care.

    The authors suggest a change in blood flow to the brain a likely cause of the patient symptoms.

    Do you have a collection of strange neurological symptoms? Do you have a history of head or neck trauma or concussion?

    Then an upper cervical evaluation could be your answer.

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    Journal of upper cervical chiropractic research March 12, 2012

    Comorbidity Of Epilepsy And Migraine

    Apart from the observation that head trauma may lead to both epilepsy and migraine, there are several possible explanations for the general comorbidity between the two conditions. Migraine attacks could be epileptogenic and over time lead to the development of epilepsy, or, alternatively, recurrent seizures could lead to the development of migraine. Epidemiological data indicate that this explanation is unlikely., If migraine caused epilepsy, for example by inducing brain injury, the incidence of an epilepsy diagnosis should be increased in individuals with preexisting migraine. The epidemiological results demonstrate that there is excess risk of epilepsy both before and after the onset of migraine, leading to the rejection of the unidirectional causality hypothesis. A similar argument suggests that epilepsy does not lead to the development of migraine.

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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.

    Link Seen Between Seizures And Migraines In The Brain

    Dr. Joseph Sirven – Tips for managing seizures, migraines and stress

    UNIVERSITY PARK, Pa. — Seizures and migraines have always been considered separate physiological events in the brain, but now a team of engineers and neuroscientists looking at the brain from a physics viewpoint discovered a link between these and related phenomena.

    Scientists believed these two brain events were separate phenomena because they outwardly affect people very differently. Seizures are marked by electrical hyperactivity, but migraine auras — based on an underlying process called spreading depression — are marked by a silencing of electrical activity in part of the brain. Also, seizures spread rapidly, while migraines propagate slowly.

    “We wanted to make a more realistic model of what underlies migraines, which we were working on controlling,” said Steven J. Schiff, Brush Chair Professor of Engineering and director of the Penn State Center for Neural Engineering. “We realized that no one had ever kept proper track of the neuronal energy being used and all of the ions, the charged atoms, going into and out of brain cells.”

    Potassium and sodium contribute the ions that control electricity in the brain. The Penn State researchers added fundamental physics principles of conservation of energy, charge and mass to an older theory of this electricity. They kept track of the energy required to run a nerve cell, and kept count of the ions passing into and out of the cells.

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    Can A Migraine Attack Cause Someone To Have A Seizure

    We dont fully understand what provokes a migraine and what provokes a seizure it could be possible that something provokes both, says Strauss.

    Headaches can occur on their own and be unrelated to seizures, or a headache can be a symptom that happens before, during, or after a seizure, says Strauss. We use the terms preictal, which is before the seizure, ictal, which is during the seizure, and postictal, which is after the seizure, she says.

    Preictal and ictal headaches are relatively rare and usually dont last long, according to the Epilepsy Foundation. Headaches that occur after a seizure are more common. A survey of 372 patients attending an epilepsy clinic found that 45 percent of them had experienced a postictal headache, and more than 1 in 5 always had one.

    Is There A Migraine And Epilepsy Connection

    What do we know about the link between epilepsy and migraines? Learn about similarities and differences in the Epsy epilepsy blog.

    A migraine is a complex condition which causes extremely painful headaches and sensory disturbances. People with epilepsy are also twice as likely to experience migraines as others. So, is there a migraine and epilepsy connection?

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    Epileptic Auras Consistently Affect One Side

    Another noteworthy difference had to do with the lateralization of the auras, which refers to how the disturbances affect all or part of the field of vision. Among those with epileptic aura, symptoms were generally restricted to one side of their visual field. In fact, 74% of patients cited that they experienced this particular sensation. In addition, the aura consistently affected the same side from episode to episode. Those in the migraine group, on the other hand, were much less likely to experience auras that only impacted a portion of their vision and even then, it was variable between attacks.

    Generally, there was not much difference in the type of symptoms observed by patients with either migraine or epilepsy auras. Both could be characterized by white spots or rings as well as negative visual symptoms such as tunnel vision or blind spots. The one notable divergence related to the spreading of the disturbance across the visual field, which occurred for one out of every three migraineurs.

    Do Migraine Attacks Trigger Seizures

    Buy Migraines and Seizures (Living With Diseases and ...

    While triggering of a seizure by migraine is unusual, headache is often associated with seizures. Preictal and ictal headaches occur rarely but postictal headache is common and may have migraine-like features. Not only does migraine-like postictal headache occur following occipital seizures, it also occurs following generalized tonicclonic seizures and can also occur following temporal lobe seizures, however, it is less likely following frontal lobe seizures or simple partial seizures. Case reports indicate that postictal headache can respond to sumatriptan. Therefore, it has been proposed that seizures can in some instances trigger trigeminovascular pain mechanisms as occurs in migraine.

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    Not All Seizures Have Genetic Cause

    Winawer and colleagues at Columbia University analyzed data from an ongoing genetic study of epilepsy families in the U.S., Canada, Argentina, Australia, and New Zealand.

    The study represents the largest collection of families with multiple members with epilepsy ever assembled, and a main goal is to determine how genes contribute to epilepsy risk.

    Winawer explains that there are many kinds of epilepsy, and many people with the condition do not have family members who are afflicted.

    Some people begin to have seizures after experiencing a blow to the head, for example.

    But she says that studying families at strong genetic risk for seizure disorders could lead to a better understanding of epilepsy, and risk for migraine.

    The analysis, which appears in the journal Epilepsia, included 730 epilepsy patients in the study from 501 families.

    An Hypothesis For Comorbidity

    Acknowledging that seizures often trigger headache, which may have migraine-like features, there remains an increased risk of migraine attacks, unassociated with seizures, in persons with epilepsy and visa versa. Given that there is little evidence to support the unilateral causality concept, it might be concluded that shared genetic risk factors are the underlying explanation for the comorbidity. This simple explanation was not supported in the epidemiological study of Ottman and Lipton. Indeed, their result might have been expected from the observation noted above that head trauma is a risk factor for both epilepsy and migraine. Ottman and Lipton therefore discarded the simple genetic risk hypothesis and instead proposed that a state of brain hyperexcitability, which can be produced either by genetic factors or can be acquired , increases the risk of both migraine and epilepsy, thus leading to the comorbid association. As discussed below, this concept is supported by a wide range of physiological evidence.

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    Are Migraines Related To Epilepsy

    Id be interested to hear about what relationship there might be between epilepsy and migraine, seeing as some epilepsy medicines work as preventives and the origins of both are rather mysterious.missmandi, Carrboro

    Dr. David Dodick of the Mayo Clinic responds:

    Migraine and epilepsy are what we call comorbid illnesses. In other words, individuals with epilepsy are significantly more likely to have migraine, and vice versa, compared with the general population.

    There are several reasons for this relationship, including a shared underlying genetic susceptibility and similar underlying biology. In both disorders, there is an increased excitability of the brain, and in those who experience migraine aura, a spreading wave of electrical activity spreads across the surface of the brain, akin to what occurs in epilepsy.

    It appears that anti-epileptic drugs that are effective for migraine suppress this spreading electrical activity, at least in animal studies. This action most likely accounts in part for why, as youve correctly pointed out, these drugs are effective for migraine as well as epilepsy.


    In Consults, an informal panel of doctors and medical scientists will take turns answering readers’ questions and writing about research in their fields how it’s likely to affect the care of patients and to expand our knowledge of human health and disease.


    Types Of Epilepsy Mistaken For Migraines

    Migraines and Epilepsy: Are They Related

    Occipital epilepsy can be mistaken for epilepsy. This type of seizure typically lasts less than a minute, whereas a migraine lasts anywhere from five minutes to an hour. Occipital epilepsy and migraines can cause someone to see multiple circular spots.

    When someone sees brightly colored spots moving horizontally and increasing in size, it is a symptom of epilepsy. If the person has a migraine, the lights spread from a single point and leave behind a degree of blindness. Someone with aural effects with a migraine may see a kaleidoscope of color for several minutes before the field of vision closes in, giving them a warning that the pain is about to start.

    An occipital lobe seizure can cause many of the symptoms of a migraine like blurred vision, visual disturbances and lack of awareness but without the headache pain a migraine would. However, most people who have migraines dont have auras or colored visual disturbances. Those who do have visual disturbances sometimes smell, hear and feel things that are not present as well. Pins and needles sensations are common if this is the case. After a migraine with an aura, limb weakness periodically occurs.

    An acute confusional migraine with its intense loss of awareness before the pain sets in can be mistaken for epilepsy. The confusion and awareness may occur seconds or minutes before the severe pain kicks in.

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    Risk Factors Mechanisms And Treatments Overlap

    Some patients with epilepsy and migraine may not report their headaches because the headaches are being effectively treated with an antiepileptic drug without a diagnosis of migraine. On the other hand, the interview used in the Epilepsy Family Study may lead to the over-diagnosing of migraine in some patients.

    Because of its greater prevalence, migraine is common in people with epilepsy, whereas epilepsy is rare in migraineurs. The diagnosis and treatment of each disorder must take into account the potential presence of the other.8

    Adapted from: Silberstein, SD, and Lipton RB. Headache and epilepsy. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann 2002 239254. With permission from Elsevier .


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