Epilepsy Talk

Epilepsy & Migraines — Kissing Cousins | September 12, 2010


A strong relationship between migraines and epilepsy has long been suspected.  But now it is fact, according to extensive research cited by Steven Karceski, MD in Practical Neurology Magazine.

People with epilepsy are more than twice as likely to develop migraine headaches as those without the disorder. Research showed that more than 20 percent of people with epilepsy have migraines, compared to 11 percent of the general population.

Evidence supports the coexistence of migraines with the following conditions:

* In migraine sufferers, 6% have epilepsy, more than ten times than the general population.

* In one study, people and their relatives who are diagnosed with epilepsy were found to be approximately 2.4 times more likely to have migraines than the control group.

* In another epilepsy study, about 16% of those people who had migraines also experienced epileptic seizures before, during or after a migraine.

* While most migraine sufferers do not have epilepsy and most people with epilepsy do not suffer from migraines, these findings still indicate a significant “overlap” of both conditions.

Epilepsy and migraines share common features, including the fact that both are episodic. Also, they share many common triggers. Foods such as chocolates, aged cheese, and red wine may trigger migraine headaches.  Alcohol (or alcohol withdrawal) can provoke a seizure. Emotional stress, poor sleep, fatigue or flashing lights are often a trigger for both seizures and headaches.

And this migraine-epilepsy duo also share some of the same symptoms: headache, abdominal pain, awareness and EEG abnormalities.  A person may have a seizure on one occasion and a classic attack of migraine on another.

Interestingly, both share common treatment options as well. The goal is to eliminate the events and prevent side effects, too. So, when a person has both epilepsy and migraines, it is logical to try to “consolidate” treatments and use one medication for both conditions.

Research shows that Depacon (Valproate) and Topamax (Topiramate) are effective in treating migraines and epilepsy.  And each has FDA approval for treating them together.  Depakote (Divalproex Sodium) also works for both, creating a therapeutic “two-fer.”

There are also several other anti-epileptic drugs that have also been shown to lessen migraine headaches – such as Neurontin (Gabapentin), Keppra ( Levetiracetam) and Zonegran (Zonisamide). However, the dose of AEDs in the treatment of migraines is usually lower than that used for epilepsy.

Drug-to-drug interactions may occur, potentially limiting the effectiveness of prescribed medications. Until further studies are completed, these agents must be used cautiously in people with either seizures, migraines, or both.

Other articles of interest:

Migraine and Epilepsy: Is There a Genetic Link Between the Two?

http://migraineadvocate.org/migraine-and-epilepsy-genetic-link/

Electronic Headband Prevents Migraines With Tiny Jolts

http://www.npr.org/blogs/health/2014/03/13/289787263/electronic-headband-prevents-migraines-with-tiny-jolts?utm_medium=facebook&utm_source=npr&utm_campaign=nprnews&utm_content=03132014

Melatonin May Aid in Migraine Prevention

http://www.medscape.com/viewarticle/781465

A Sleep Gene Has A Surprising Role In Migraines

http://www.medpagetoday.com/Neurology/Migraines/38917?isalert=1&uun=g678261d88R5845718u&utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news&xid=NL_breakingnews_2013-05-06

FDA: Migraine Drugs Dangerous in Pregnancy

http://www.medpagetoday.com/Neurology/Migraines/38917?isalert=1&uun=g678261d88R5845718u&utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news&xid=NL_breakingnews_2013-05-06

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Resources:

Steven Karceski, MD, Practical Neurology, March 2007

http://www.columbiaepilepsy.org/docs/patients/March%202007.pdf

http://www.columbia.edu/cu/record/archives/vol20/vol20_iss16/record2016.15.html

http://www.docstoc.com/docs/20011979/Epilepsy-Migraine—More-than-just-a-headache/

http://www.realage.com/check-your-health/chronic-pain-management/medical-conditions-associated-with-migraines


16 Comments »

  1. I have migraines sometimes. When I was put on Neurontin, it cleared up my migraines. My doctor always told me that if I wanted a headache, take an aspirin.

    I found that when I quit taking aspirin my headaches went away. I found that interesting.

    Comment by Ruth Brown — September 17, 2010 @ 6:28 AM

    • Certain over-the-counter medications (Advil and Tylenol are fine but never take aspirin!) can make you more likely to have a seizure, if you have epilepsy or a history of seizures. For example, anti-depressants and antihistamines are possible seizure triggers. Also certain supplements — like evening primrose oil — can also be a trigger.

      Comment by Phylis Feiner Johnson — September 17, 2010 @ 8:54 PM

  2. I have a acute migraine disorder that began right after I had my son, 14 years ago, and my son was diagnosed with Epilepsy 8 years ago. Both of our neurologists have said there is some tie in but neither can pin-point it. There is no family history of migraines or Epilepsy, but my father had an arachenoid cyst in his brain and my grandfather had a brain tumor!

    Comment by Jennifer — January 21, 2012 @ 8:23 PM

  3. Well the migraine was probably caused by hormonal changes with a bit of sleep deprivation and stress mixed in.

    http://www.loveyourbaby.com/headaches-and-breastfeeding.html

    As for the epilepsy, the only tie I know of is the actual personal with epilepsy / migraines having the other as a co-existing condition.

    A personal with a brain tumor certainly can (and usually does) have seizures…but that was a brain tumor 2 generations ago.

    “The risk for developing epilepsy does not seem to be increased, compared with the general population, in relatives of people who have epilepsy caused by serious brain injury that occurs after birth due to conditions such as strokes, brain tumors, severe head trauma or brain infections.”

    http://www.epilepsyfoundation.org/livingwithepilepsy/gendertopics/womenshealthtopics/genetics-and-epilepsy.cfm

    So, I can see why you have your neuros guessing. There could be some wildcard gene there that was a marker, but chanced are, it will remain a mystery.

    Comment by Phylis Feiner Johnson — January 22, 2012 @ 2:54 PM

  4. Epilepsy and migraine ‘could have shared genetic link’

    A strong family history of seizures could increase the chances of having severe migraines, says a study in Epilepsia journal.

    Scientists from Columbia University, New York, analysed 500 families containing two or more close relatives with epilepsy.

    Their findings could mean that genes exist that cause both epilepsy and migraine.

    Epilepsy Action said it could lead to targeted treatments.

    Previous studies have shown that people with epilepsy are substantially more likely than the general population to have migraine headaches, but it was not clear whether that was due to a shared genetic cause.

    The researchers found that people with three or more close relatives with a seizure disorder were more than twice as likely to experience ‘migraine with aura’ than patients from families with fewer individuals with seizures.

    “By understanding how genes work, more targeted treatments could be developed in the future.”

    Simon Wigglesworth — Epilepsy Action

    Migraine with aura is a severe headache preceded by symptoms such as seeing flashing lights, temporary visual loss, speech problems or numbness of the face.

    Dr Melodie Winawer, lead author of the study from Columbia University Medical Centre, said the findings had implications for epilepsy patients.

    “Our study demonstrates a strong genetic basis for migraine and epilepsy, because the rate of migraine is increased only in people who have close (rather than distant) relatives with epilepsy.”

    She said further studies of disorders coupled with epilepsy could help “enhance the quality of life for those with epilepsy”.

    In the study, Dr Winawer and colleagues analysed data collected from the Epilepsy Phenome/Genome Project – a genetic study of epilepsy patients and families from 27 clinical centres in the US, Canada, Argentina, Australia, and New Zealand.

    Simon Wigglesworth, deputy chief executive at Epilepsy Action, said the research was encouraging.

    “Having a better understanding of the genetic link between epilepsy and other medical conditions can only be a good thing.

    “It means that steps can be taken to improve diagnosis and treatment for people living epilepsy and co-existing conditions. By understanding how genes work, more targeted treatments could be developed in the future.”

    http://www.bbc.co.uk/news/health-20908903

    Comment by Phylis Feiner Johnson — January 7, 2013 @ 2:15 PM

  5. Epilepsy And Migraine Genetic Link

    http://www.medicalnewstoday.com/releases/254662.php

    Comment by Phylis Feiner Johnson — January 10, 2013 @ 10:30 AM

  6. I think I have my first migraine. :-(

    Driving headaches, nausea, blurred vision.

    My head feels like it’s racing inside at 100 mph. (Just like the nocturnal seizures I used to get when I was a kid.)

    Help! (No more medications please.)

    Comment by Phylis Feiner Johnson — May 28, 2013 @ 5:39 PM

  7. I have seizures and my sister has migraines. I wonder if we are different sides of the same coin??

    Comment by Doug — June 14, 2013 @ 2:09 AM

  8. Good question. No answer. :-(

    But, I do know that research shows Depacon (Valproate) and Topamax (Topiramate) are effective in treating migraines AND epilepsy.

    And each has FDA approval for treating them together.

    Depakote (Divalproex Sodium) also works for both, creating a therapeutic “two-fer.”

    There are also several other anti-epileptic drugs that have also been shown to lessen migraine headaches – such as Neurontin (Gabapentin), Keppra ( Levetiracetam) and Zonegran (Zonisamide).

    However, the dose of AEDs in the treatment of migraines is usually lower than that used for epilepsy.

    Comment by Phylis Feiner Johnson — June 14, 2013 @ 11:27 AM

  9. My sister’s migraines always seem to be around her “time of the month” and I pointed out to her how seizures can be hormone related, but her docs just tell her that she’ll just have to wait till menopause…

    They currently have her taking Imitrex as needed when she has those headaches. She worries about that though because she will feel strange (like she is having a stroke, but not) sometimes when she takes the Imitrex.

    Comment by Doug — June 15, 2013 @ 2:15 AM

  10. Imitrex seems to be the standared protocal for migraines.

    And she might have Catamenial Epilepsy

    http://epilepsytalk.com/2011/08/07/catamenial-epilepsy-%E2%80%93-do-you-have-it/

    Do any of these symptoms ring true?

    Comment by Phylis Feiner Johnson — June 15, 2013 @ 12:40 PM

  11. I don’t think she has ever had seizures. Unless a partial could somehow show the same symptoms as a migraine headache.

    Comment by Doug — June 15, 2013 @ 12:52 PM

  12. This is the closest answer to your question that my research came up with:

    Migraine triggered seizures and epilepsy triggered headache and migraine attacks: a need for re-assessment

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094670/

    Comment by Phylis Feiner Johnson — June 16, 2013 @ 5:38 PM

  13. i was given topamax , for mine til it cause issues with , my HBP meds .. pharmacist ,even dr , said it was ok , saw it in the reader Tompamax hands out with the meds .. being ex pharmacy tect , i checked it out in my PDR . yup , it did , took the book to the pharmacist, even the nurse on duty , in neruo , both couldnt believe it ..my GP dr knew & removed me off the meds .. has me on another med .. but , Excedrin , migraine , works best instead .. has same ingredient as the RX , plus cheaper ..

    Comment by cathy — April 25, 2014 @ 2:59 PM

  14. That’s really interesting Cathy. Thanks for sharing your experience.

    Comment by Phylis Feiner Johnson — April 25, 2014 @ 4:43 PM


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    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I've also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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