Chapter 14 entitled " Migraine and Epilepsy "

Abstract

Migraine and epilepsy are both characterized by transient attacks of altered brain function with a clinical, pathophysiological and therapeutic overlap [1–9]. Furthermore, epilepsy and migraine may mimic each other. In particular, occipital lobe seizures may be easily misinterpreted as migraine with visual aura [10]. The frequency of epilepsy among people with migraine (range 1–17%) is higher than in the general population (0.5–1%), just as the prevalence of migraine among patients with epilepsy is also higher (range 8–15%) than that reported in healthy individuals [3, 11-16]. Especially in children this comorbidity is found often [17]. Some studies of the association between migraine and specific epilepsy syndromes, such as childhood epilepsy with occipital paroxysms and benign childhood epilepsy with centrotemporal spikes (CTS) were negative [6,18], but others were positive [3, 19-24]. An increase in (usually unspecific) electroencephalographic (EEG) abnormalities in patients suffering from migraine [9], has been considered as evidence of a relationship between migraine and epilepsy [10, 11]. The mechanism underlying the onset of a migraine attack is probably cortical spreading depression (CSD). Unlike epileptiform abnormalities in epilepsy attacks, CSD is not demonstrable in migraine patients which clearly hampers studies addressing the pathophysiological overlap between migraine and epilepsy attacks