Department of Neurology

Are migraines related to seizures?

Q: Is there a relationship between seizures and migraines? My mother experiences flashes of light and alteration in her visual field (central vision is gone, and her peripheral vision barely remains; she cannot read even large words that are right in front of her). She also feels somewhat dizzy, with a sense of impending doom that makes her instictively seeks a dark, quiet, and isolated spot where she can rest. Following this experience, she will sometimes get a full-blown migraine headache. Usually, though, she will get only the visual and "mental" experiences that normally preceed the headache, without getting the headache itself. Her symptoms usually subside after she has been resting for a while. She has never, to her knowledge, had a seizure.

A: Population studies suggest that the prevalence of epilepsy is higher in persons with migraine and vice versa. The problem with firmly establishing a link is that migraine is a very common illness anyway. Scientist suggest that both seizures and migraines share similar brain mechanisms. In practice, some medications that are effective against seizures are also effective against migraine. The anticonvulsant, valproate (Depakene/ Depakote) is indicated by the FDA for treatment of migraines.

Some patients who have migraine also have loss of consciousness directly due to the migraine, rather than an independent seizure disorder. In these persons, treatment of their migraines may be all that is needed. Often it is difficult to sort how much to attribute the problems to migraines and how much to attribute to epilepsy. In this situation, video-EEG monitoring may be helpful to sort out the spells. What you describe sounds more migrainous; your mother should have a full neurologic evaluation to determine this.

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