Epilepsy Talk

Epilepsy & Migraines — Kissing Cousins | April 27, 2017

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.

The International Headache Society (IHS) criteria divides headache disorders into two main groups, with similarities to groups of epilepsies:

Secondary headaches, symptomatic of an underlying condition such as trauma or a mass lesion. This group is analogous to the symptomatic epilepsies.

Primary headaches, with no identifiable underlying cause. This group includes migraine, tension-type headache, cluster headache, and a number of rare disorders; it is analogous to the idiopathic epilepsies.

People with epilepsy are more than twice as likely to develop migraine headaches as those without the disorder.

And research has shown 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.

To subscribe to Epilepsytalk.com and get the latest articles by email, simply go to the bottom box of the right column and click on “Follow”

Other articles of interest:

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

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

 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

Resources:

Steven Karceski, MD, Practical Neurology, March 2007

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

http://www.neurologyadvisor.com/epilepsy/epilepsy-migraine-disorder-similarities/article/443017/

http://www.epilepsy.com/information/professionals/co-existing-disorders/migraine-epilepsy


32 Comments »

  1. I never had headaches when I was suffering with epilepsy. I had headaches a after my brain operation , but to this day I do not get aches.

    Like

    Comment by Jill Whiting — April 27, 2017 @ 4:31 PM

  2. Great article, thanks for posting. I have both epilepsy and migraines so it grabbed my attention right away. One other thing that caught my attention was the comment about abdominal pain. About 20 years before my seizures started I was diagnosed with a condition called Cyclical Vomiting Sydrome (CVS). I’m just curious if any or your readers have ever been diagnosed with this and epilepsy and if anyone has ever connected the two.
    Thanks,
    Dennis

    Like

    Comment by Dennis Crocker — April 27, 2017 @ 7:51 PM

    • Look what I found! It’s a migraine connection.

      “Although the specific cause of cyclic vomiting syndrome is unknown, there are likely to be several contributing causes.

      Researchers have found a strong relationship between CVS and migraines, and some theorize that CVS is a migraine variant.

      Most children with CVS have a family history of migraines or have migraines themselves (> 80%).

      CVS has been referred to as ‘abdominal migraine’ and the terms are sometimes used interchangeably.

      An abdominal migraine is a migraine variant in which there are recurrent episodes of predominating abdominal pain.

      Vomiting may or may not accompany an abdominal migraine.”

      https://rarediseases.org/rare-diseases/cyclic-vomiting-syndrome/

      “The disease is characterized by repeated stereotypical vomiting episodes accompanied by severe nausea and/or headache, with episodes typically occurring early in the morning, Dr. Rothner explained.

      In the study population, ‘patients reported cycles with a median duration of 24 hours, 18 vomiting episodes per cycle, and a peak of five vomits per hour at four-week intervals,’ the researchers wrote.

      ‘Twenty-six percent of patients had a personal history of migraine … 71% had a family history of migraine, and 10% had a family history of EPILEPSY,’ Dr. Rothner said, noting that cyclic vomiting syndrome is considered one of the three primary migraine variants.

      Approximately two-thirds (66%) of the patients had some identifiable triggers, including viral illness and motion sickness.

      Autonomic symptoms, including fever and hypertension, were seen in 25%.”

      http://www.mdedge.com/neurologyreviews/article/73077/headache-migraine/metabolic-abnormalities-are-implicated-pediatric

      “The concept of the “CVS threshold” is put forth in parallel with exploring the remarkable similarity of adult CVS with features of chronic migraine, EPILEPSY, and panic disorder.”

      http://www.nature.com/ctg/journal/v7/n10/full/ctg201655a.html

      Like

      Comment by Phylis Feiner Johnson — April 27, 2017 @ 8:20 PM

      • Some great links, I’ve seen most of them. Obviously I went thru a huge amount of testing before I was given this diagnosis. While CVS is mostly considered a children’s disease and they frequently grow out of it they tend to evolve into migraines for a good percentage of children as the vomiting attacks subside, my CVS actually increased as I got older, I never thought much of it when I was a kid and lived in a very small area but as the cycle became more frequent and I had moved too a large city that I actually got a diagnosis.

        Since my seizures started my epileptologist, who is also a migraine specialist thought it was possible that there might be a connection between all 3. Since CVS is a bit of a rare disorder I was curious too know if any of your followers had been diagnosed with both epilepsy and CVS.

        Dennis

        Like

        Comment by Dennis Crocker — April 28, 2017 @ 6:54 PM

      • Wow, Denis, you’ve been through so much.

        I’m sorry I wasn’t able to help you. 😦

        Like

        Comment by Phylis Feiner Johnson — April 29, 2017 @ 7:20 AM

  3. I don,t get headache,s like I use to. from last eeg I was told what I had was not seizures. most of the aura,s hasn,t been bothering me , but last night trying to get me every few minute,s.They are a new since.

    Like

    Comment by Michele Metzger — April 27, 2017 @ 7:55 PM

  4. MIGRAINE HEADACHES I do not have BUT I only think of a special gal I knew from grade & HIGH school in the 1970’s. At 11 years old when in 6th grade, she stayed home from school more than a few times & at times 2 weeks or more when MIGRAINES were attacking her brain. I thought then something was wrong with her, but she just lived with it up through 12th grade, & we graduated. After 22 years later at age 39, M S was diagnosed then in 1999, & then I called her about the FOODS we both ate & compared some thing with our 2 diets. She noticed as I did when we were in school what was happening to her when NITRATES & MSG’s were making her feel that way she did, as with me, I was having PETIT MAL SEIZURES from basically all the same foods we ate, BUT FOOD CHEMICALS in the 1970’s & in 2017 NEVER is any SERIOUS TOPIC to be concerned about making THAT THE ISSUE of being a ROOT CAUSE & RELATIONSHIP / CONNECTION as WHY people have seizures or MIGRAINES, and how all types of seizures can be caused form the food chemicals & how like 95% of all foods today are CONTAMINATED with them, even the GMO so called ORGANIC FOODS, So there,, Myself & my classmate with 2 TWO different brain conditions, BOTH we believe has A LOT to do with our diets, as our parents were NEVER educated about food chemicals. Oh yeah, her father was a dentist, who also used Mercury WITH Aluminum for fillings in her mouth plus her 2 brothers & 4 sisters. Have no idea how they have lived but it ALWAYS seems like there is 1 that suffers in every family. You better believe NO MERCURY is in my mouth after her dad did a few fillings for me as a teenager. At age 40 ALL mercury was gone from my teeth. Mercury can cause all 3 MIGRAINES, MS & SEIZURES plus anything else that makes the brain just not be normal.

    Like

    Comment by C D — April 27, 2017 @ 9:28 PM

    • Interesting that you should mention mercury, C D.

      I had a doctor/dentist write to me and suggested the subject of mercury’s poison as an article.

      I agree with you, in every way.

      Like

      Comment by Phylis Feiner Johnson — April 27, 2017 @ 10:28 PM

  5. I have always noticed migraines as the coal mine canary for my epilepsy. If I get a bad headache, I know that something is “out of whack” in my diet/lifestyle choices and needs to change (e.g. more sleep, less sugar, less caffeine).

    Like

    Comment by paleobird — April 28, 2017 @ 1:52 AM

  6. I don,t know, I hope not to me it,s just a headache, I don,t get them all the time.

    Like

    Comment by Michele Metzger — April 28, 2017 @ 7:38 PM

  7. The Daith piercings in both ears really do help with migraines! I also took note, that my seizures went crazy with one out. My speech was messed up, couldn’t think right, lost track of time, and etc. Also, my service dog 🐶 on a whining spell the whole time. Once, I got the one that fell out back in, in about two hours I was alright. At least, I could listen to music again.

    Like

    Comment by Kathleen Benshoff — April 28, 2017 @ 11:07 PM

    • Kathleen, I’ve heard about them but what’s their secret? How and why do they work?

      I have to admit that, although I have no migraines, I’d be too chicken to try them anyway. (Needles are not my friends!)

      Like

      Comment by Phylis Feiner Johnson — April 29, 2017 @ 7:05 AM

      • It is pretty much like 24 hrs a day and 7 days a week, acupuncture. The secret is you have to have patience and the ability to with stand some pain. No pain no gain. I have been an epileptic since I was 4 months. The migraines since I was 9 or 10. I think it was a couple of weeks or maybe a month or two after I got the piercings that they really started working. I noticed that I could listen to music and things loud again. Now yesterday, I noticed I had more seizures with just one out.

        Like

        Comment by Kathleen Benshoff — April 29, 2017 @ 10:30 PM

  8. Migraine headaches are awful!! I get them a lot. My headaches are stress related and also weather related. I have a build up of scar tissue behind my left eye. It is from two Neuro surgeries. It swells up when the air pressure gets high and when it is humid. Right before a storm starts I get a piercing pain and within ten to fifteen minutes the storm starts. My left eye swells up. Family and friends tease me, “the walking barometer” they call me. I will be asked how long before it starts, do they have time to get a round of golf in!! Lol!!

    Like

    Comment by Nicole Koloski — April 29, 2017 @ 5:18 PM

    • Atmospheric Conditions
      Changes in air pressure or any sudden action, (like arising from a prone position too quickly), can act as an instant stressor. Like taking off or landing in an airplane…going up or down on a fast elevator or escalator…
      Barometric Pressure
      Weather differences such as sudden changes in temperature, dark skies, thunder, or bright, hot sunlight and humidity may be a definite trigger for some.

      Like

      Comment by Phylis Feiner Johnson — April 30, 2017 @ 4:37 PM

    • Nicole Koloski, I get the post-ictal migraines as well. They are hellishly painful.

      Like

      Comment by Jeffrey Liakos — September 21, 2017 @ 2:02 PM

    • Nicole Koloski, the headaches are intolerable.

      Like

      Comment by Jeffrey Liakos — October 21, 2017 @ 12:56 PM

  9. I do suffer from chronic migraines but haven’t had seizure in 24yrs. Also have abdominal pain. They can’t seem to figure out

    Like

    Comment by Terri — April 30, 2017 @ 1:02 PM

    • Are you familiar with “Abdominal Migraines”?

      They present with episodes of abdominal pain without any accompanying headache.

      It is difficult to confirm the diagnosis as there are not a set of features that is specific and thus it can take time before the diagnosis is made.

      Like

      Comment by Phylis Feiner Johnson — April 30, 2017 @ 5:00 PM

  10. Thanks for this article as well as many others Phyllis. I have suffered with this condition since five years old. So bad, that I was often home schooled as a child. I also did not receive any support from my mother or family. She was in complete denial. When one of these bad headaches would come, she would just dismiss it and claim, I wanted attention. It became the families, dirty little secret. It wasn’t until decades later that I was diagnosed with epilepsy. After several medications, I now take Zonegram. It has been the most helpful. Seizures are very limited, I hope one day they will eventually stop altogether.

    I’m also thankful for the other commenters, you also have helped and encouraged me to get through the tough days.

    Sincerely, Lee

    Like

    Comment by Lee — April 30, 2017 @ 9:00 PM

    • First of all, thank for your encouragement, Lee.

      Epilepsy was MY dirty little secret. My parents treated me like a pariah and the “E” word was never uttered.

      So even though our conditions may be different, it seems like we come from a similar place.

      Like

      Comment by Phylis Feiner Johnson — May 1, 2017 @ 9:35 AM

  11. Can you use footnotes so it’s clearer what part of your blogs you’re getting your information from?

    Like

    Comment by Denise — May 1, 2017 @ 9:11 PM

  12. I use to go through more migraine headaches before my brain surgeries years ago.

    I still have them from time to time, but nothing in comparison to what I did in past. Nor as severe as they were when I do have 1.

    Like

    Comment by Lori Lewis — September 30, 2017 @ 10:51 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I 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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