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Comorbidity of epilepsy and migraines epidemiological and clinical aspects

Abstract

In patients with migraines, epilepsy occurs in 5.9% (1-17%) of cases compared to a prevalence of 0.5-1% in the general population. Comorbidity of migraines and epilepsy can be explained by neuronal hyperexcitability, while cortical spreading depression is considered to be a pathophysiological mechanism that lies in the basis of the migraine aura. The study included 259 patients with epilepsy and 40 patients with both epilepsy and migraines. The aim of the investigation was to determine the prevalence of migraines, the existence of a temporal association between epileptic and migraine attacks, to determine the clinical characteristics of joint epileptic and migraine attacks, the existence of a significant connection between a certain type of epileptic seizure and type of headache, and finally to determine heredity for epilepsy and migraines in patients who have these conditions associated. Patients were diagnosed clinically, neurophysiologically and neuroradiologically. The research results show that the frequency of associated epilepsy and migraines occurred in 15.44%. The results of this investigation point to a significantly higher frequency of epilepsy and migraines in female patients (ratio 5 : 1), which is different from the data we found in existing studies. Temporally connected attacks of epilepsy and migraines were observed in 48% of patients. Preictal headaches appeared in 20% of patients, postictal in 28% of patients. There was no significant association between migraines and the particular type of epileptic attack. Heredity for migraines was present in 35% of patients with both epilepsy and migraines. This data is significantly lower than the data found in other studies

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