Epilepsy Talk
Epilepsy & Migraines — Kissing Cousins | May 7, 2022
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.
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Resources:
Steven Karceski, MD, Practical Neurology, March 2007
https://www.webmd.com/epilepsy/migraine-epilepsy-link
https://www.epsyhealth.com/seizure-epilepsy-blog/is-there-a-migraine-and-epilepsy-connection
https://www.neurologyadvisor.com/topics/epilepsy/epilepsy-and-migraine-a-common-ground/
https://www.healthline.com/health/migraine/migraine-and-seizure
http://www.columbia.edu/cu/record/archives/vol20/vol20_iss16/record2016.15.html
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My daughter suffers with epilepsy and just started getting migrains. He neurologist is treating her for both.
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Comment by Gwen Keno — May 7, 2022 @ 10:46 AM
Reblogged this on Disablities & Mental Health Issues.
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Comment by Kenneth — May 7, 2022 @ 11:11 AM
My father in the late 1960’s & all through the 70’s had migraine or tension headaches, but would never think what I said was right about ANYTHING when as a young teen from a kid told him he has headaches like I had seizures from the SAME FOODS WE BOTH ATE. But O was crazy until he started to see my neurologist that I was seeing after 7 years, then HE SAID to my father that FOODS with nitrates & nitrites will make people get headaches. So I am thinking FINE, What about my seizures from the same foods I was eating as my father was, and that neurologist said YOU’RE COMPARING ORANGES TO APPLES & I thought then BS, when I saw what foods that had been causing my seizures were the SAME FOODS that made my father headaches happen. So ALL NITRATES, NITRITES & MSG FOODS will make both the headaches & seizures to happen as BOTH condition will later effect the heart, as my father has been gone for over 17 years & for over 61 years I can still have seizures.
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Comment by James D — May 7, 2022 @ 2:42 PM
I suffer with epilepsy on enough medication, and my Son has suffered from migraines!!?!
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Comment by robert joseph rimmer — May 8, 2022 @ 3:59 AM
You can’t catch a break either way. 😥
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Comment by Phylis Feiner Johnson — May 8, 2022 @ 10:39 AM
I experience headaches along with my epilepsy. Even though there are times the headaches can be really irritating, and light bothers me, I have always attributed my headaches to my brain surgery that I had in 2014. I had a partial resection of a brain tumor. I have never received the diagnosis of migraine, but when I was diagnosed with med-resistant epilepsy and my brain tumor 2012 I had already experienced daily excruciating headaches. I do not notice a warning when I am going to have a headache, but many people with migraines also experience an aura.
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Comment by Gwen S — May 8, 2022 @ 3:17 PM
The Epilepsy for me is enough of a hassle. Ensuing migraines are much worse.
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Comment by ragnarsbhut — October 16, 2022 @ 12:04 AM
Excedrin Migraine: is it safe for epilepsy patients? Is it helpful?
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Comment by Martha — February 3, 2023 @ 12:15 PM
Basically there are two medical approaches to treat your headaches. The first approach is to wait until a headache begins and then stop it. Over-the-counter pills like aspirin, Tylenol (acetaminophen) or Advil (ibuprofen) may do the job, or you may need a prescription for something like Anaprox (naproxen) or Fiorinal (a combination of butalbital, aspirin, and caffeine). For migraine headaches, which involve the blood vessels in the brain, prescription medications called triptans are especially effective. Brand names for various types include Imitrex, Zomig, Amerge, and Maxalt. The triptans are available in several forms. Which one your doctor prescribes will depend on your needs and preferences.
The second approach is to prevent headaches from occurring at all. Your doctor may call this “prophylactic” (pro-fuh-LACK-tic) treatment or “prophylaxis” (pro-fuh-LACK-sis). In this kind of treatment, you take medication every day to prevent future headaches. The seizure medicine Depakote (valproate) is approved for use in preventing headaches and might be the first choice when both headaches and seizures need treatment. Other medications often used to prevent headaches include beta-blockers such as Inderal (propranolol), calcium channel blockers such as verapamil, and Elavil (amitriptyline). https://www.epilepsy.com/stories/seizures-and-headaches-they-dont-have-go-together
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Comment by Phylis Feiner Johnson — February 3, 2023 @ 1:14 PM
Thank you, Phyllis, but this does not answer my specific question about Excedrin Migraine. My son is the one who has the migraines, not me. He also has a history of seizures, which have been well controlled for the past 7 years with Aptiom. He has not had migraines during that period either. I believe the current one was triggered by extreme cold weather in the Northeast.
When he used to get frequent migraines (before Aptiom), we tried all the standard treatments: triptans (useless), daily medications, other AEDs, etc. All were ineffective, or worse. Depakote was a disaster (he cried all the time, was very depressed).
We need something that works when the person has an attack, and do not want to change his AED.
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Comment by Martha — February 3, 2023 @ 2:21 PM
The only option I know of is Botox injections for migraines.
https://americanmigrainefoundation.org/resource-library/botox-for-migraine/
But I did find this:
What OTC medications are considered safe for use by people with epilepsy?
Medicines for runny and stuffed noses containing pseudoephedrine or phenylephrine appear to be relatively safe, but there are reports of seizures caused by these drugs too. Read the labels and talk to your health care provider.
Nasal saline sprays are safe to use for runny or stuffed noses from allergies or colds.
For aches and pains, acetaminophen (such as Tylenol, Panadol, EXCEDRIN ASPIRIN FREE) is probably the safest medication.
Aspirin also appears safe, but it should not be given to children. https://www.epilepsy.com/what-is-epilepsy/seizure-triggers/over-counter-medications
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Comment by Phylis Feiner Johnson — February 3, 2023 @ 3:44 PM