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Treatment
Prevention
Epilepsyandmigraineare complex brain disorders, and having one increases your chance of having the other. Despite being distinct conditions, epilepsy and migraine share several features, including triggers, symptoms, and treatments. These similarities perhaps provide insight into how the two disorders are connected.
This article explores the relationship between epilepsy and migraine, including how they can be managed simultaneously.
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Connection Between Epilepsy and Migraine
Migraine and epilepsy share similar biologies, triggers, and symptoms, like headache and aura. A migraine may even trigger a seizure in rare instances.
Biology
Epilepsy and migraine are diseases involving abnormal brain electrical activity, specifically an initial period of excessive nerve cell excitability.
What Is Cortical Spreading Depression?Cortical spreading depression is a wave of electrical activity that moves through the brain, activating pain-sensing nerves, narrowing blood vessels, and generating a migraine headache.
What Is Cortical Spreading Depression?
Cortical spreading depression is a wave of electrical activity that moves through the brain, activating pain-sensing nerves, narrowing blood vessels, and generating a migraine headache.
Triggers
Examples of shared environmental triggers with migraineor epilepsyinclude:
Headache as a Symptom
Headaches occur in migraine and epilepsy.
Throbbing headaches that resemble migraines commonly occur with seizures, especially in thepostictal state, the recovery period following a seizure.
Postictal headaches occur in around 45% of people with epilepsy and may accompany other postictal symptoms like confusion, tiredness, or dizziness.
Migraine-like headaches can also occur in theictal state, the active stage of a seizure when bursts of electrical activity occur in the brain. Ictal headaches are overall not as common as postictal headaches.
An Overview of Seizure Phases
Aura as a Symptom
Another symptom, an aura, may occur with seizures and migraine attacks.
Migraine aurasprecede around 15% to 30% of migraine headaches and are typically associated with visual symptoms like seeing zigzag flashing lights or bright shapes.
Sensory disturbances (e.g., numbness and tingling on parts of your body) and speech, hearing, or motor (movement-related) symptoms may also be present during a migraine aura.
Epileptic aurasoccur in nearly 60% of people withfocal epilepsy(seizures that begin in one area of the brain) and 13% with generalized epilepsy (seizures that start on both sides of the brain).
Epileptic auras are commonly associated with stomach discomfort or psychic feelings of déjà vu, fear, or impending doom. These auras may also cause neurological disturbances, similar to a migraine aura, such as vision, sensory, or hearing symptoms. (e.g., ringing or buzzing sounds in both ears).
Migraine Aura-Triggered Seizure
A Diagnosis Under DebateSome experts question the existence of migraine aura-triggered seizures, considering they are so rarely reported.It’s possible that the migraine aura precedes the seizure—a preictal migraine attack—and doesn’t trigger it.
A Diagnosis Under Debate
Some experts question the existence of migraine aura-triggered seizures, considering they are so rarely reported.It’s possible that the migraine aura precedes the seizure—a preictal migraine attack—and doesn’t trigger it.
Compared to the general population, people with epilepsy are approximately twice as likely to have migraine.Likewise, people with migraine have a higher chance of having epilepsy, although other risk factors, like a history ofhead trauma, are also usually present.
Experts haven’t teased out precisely why having epilepsy increases the risk of migraine and vice versa. It doesn’t appear that one condition directly causes the other.
Instead, environmental factors like brain injury probably explain some cases of coexisting epilepsy and migraine. Genetic factors may also play a role.
Supporting a genetic link between the conditions is that several commongenetic mutations(changes inDNA) have been discovered in families with migraine and epilepsy.
Many of these genetic mutations lead to an imbalance between excitatory and inhibitory chemicals in the brain. This chemical imbalance plays a crucial role in the pathogenesis of epilepsy and migraine.
It’s important to note that while epilepsy and migraine may coexist, there is no evidence to suggest one condition necessarily aggravates the other.
That said, they may have compounding psychological effects. Epilepsy and migraine are both associated with a poorer quality of life and psychological difficulties such as depression, anxiety, and sexual dysfunction.
Coping With Epilepsy
Treatment and Management of Epilepsy With Migraine
Certain epilepsy and migraine medications are used to manage both conditions.
Topamax(topiramate)and Depakote (valproate) are two prime examples. These medications are used for migraine prevention, although they were initially developed for epilepsy.
Migraine-prevention medicationhelps reduce the number and severity of migraines. Likewise, anti-seizure medications are intended to reduce the number or severity of a person’s seizures.
Starting an anti-seizure medication (that may also be used to prevent migraine) requires a close discussion with your healthcare provider. Such medications can cause varying side effects and must be taken daily to be effective.
Keep in mind that an anti-seizure medication is ineffective at treating acute migraine attacks. Acute migraines are treated with anonsteroidal anti-inflammatory drug (NSAID)like Advil or Motrin (ibuprofen). More severe or persistent migraine attacks may require a triptan, such as Imitrex (sumatriptan).
Migraine Treatments: Everything You Need to Know
There is no surefire way to prevent migraines from developing after being diagnosed with seizures or vice versa. However, similar preventive strategies can help you control both disorders.
Trigger Avoidance
Since epilepsy and migraine share triggers, identifying and avoiding these triggers (if they affect you) could help you have fewer seizures or migraines. Starting a seizure andmigraine diary, or downloading an app likeMigraine Buddyor My Seizure Diary, can help you track potential triggers.
Healthy Lifestyle
Adopting healthy lifestyle habits can also improve your seizure and migraine control. Such habits include:
What Is Epilepsy?
Summary
Epilepsy and migraine are brain conditions with overlapping features. Having epilepsy increases your chances of developing migraine and vice versa. Complex genetic and environmental factors likely explain why the conditions sometimes coexist. There is no evidence that one directly causes the other.
Besides sharing triggers and symptoms, certain medications can treat both conditions simultaneously. Healthy lifestyle habits that avoid triggers may also help.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mantegazza M, Cestèle S.Pathophysiological mechanisms of migraine and epilepsy: Similarities and differences.Neurosci Lett. 2018;667:92-102. doi:10.1016/j.neulet.2017.11.025Auffenberg E, Hedrich UB, Barbieri R, et al.Hyperexcitable interneurons trigger cortical spreading depression in an Scn1a migraine model.J Clin Invest. 2021;131(21):e142202. doi:10.1172/JCI142202National Institute of Neurological Disorders and Stroke.Headache: hope through research.National Institute of Neurological Disorders and Stroke.The epilepsies: hope through research.American Migraine Foundation.The timeline of a migraine attackKim DW, Lee SK.Headache and epilepsy.J Epilepsy Res. 2017;7(1):7-15. doi:10.14581/jer.17002American Brain Foundation.Disease connections: migraine and epilepsy.Lucas C.Migraine with aura.Rev Neurol (Paris). 2021;177(7):779-784. doi:10.1016/j.neurol.2021.07.010Spencer D.Auras are frequent in patients with generalized epilepsy.Epilepsy Curr. 2015;15(2):75-77. doi:10.5698/1535-7597-15.2.75International Headache Society Classification ICHD-3.Migraine-aura triggered seizure.Sforza G, Ruscitto C, Moavero R, et al.Case report: migralepsy: the two-faced Janus of neurology.Front Neurol. 2021;12:711858. doi:10.3389/fneur.2021.711858Keezer MR, Bauer PR, Ferrari MD, Sander JW.The comorbid relationship between migraine and epilepsy: a systematic review and meta-analysis.Eur J Neurol. 2015;22(7):1038-1047. doi:10.1111/ene.12612Spillane J, Kullmann DM, Hanna MG.Genetic neurological channelopathies: molecular genetics and clinical phenotypes.J Neurol Neurosurg Psychiatry. 2016;87(1):37-48. doi:10.1136/jnnp-2015-311233Liao J, Tian X, Wang H, Xiao Z.Epilepsy and migraine-are they comorbidity?Genes Dis. 2018;5(2):112-118. doi:10.1016/j.gendis.2018.04.007Mirmosayyeb O, Shaygannejad V, Ghajarzadeh M.Comparison of psychological difficulties in patients with migraine and epilepsy using PARADISE-24 questionnaire.J Multidiscip Healthc. 2020;13:609-613. doi:10.2147/JMDH.S260056Loder E, Burch R, Rizzoli P.The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines.Headache.2012;52(6):930-945. doi:10.1111/j.1526-4610.2012.02185.x Note to copy editor: This is the most current clinical guideline, so appropriate to cite.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mantegazza M, Cestèle S.Pathophysiological mechanisms of migraine and epilepsy: Similarities and differences.Neurosci Lett. 2018;667:92-102. doi:10.1016/j.neulet.2017.11.025Auffenberg E, Hedrich UB, Barbieri R, et al.Hyperexcitable interneurons trigger cortical spreading depression in an Scn1a migraine model.J Clin Invest. 2021;131(21):e142202. doi:10.1172/JCI142202National Institute of Neurological Disorders and Stroke.Headache: hope through research.National Institute of Neurological Disorders and Stroke.The epilepsies: hope through research.American Migraine Foundation.The timeline of a migraine attackKim DW, Lee SK.Headache and epilepsy.J Epilepsy Res. 2017;7(1):7-15. doi:10.14581/jer.17002American Brain Foundation.Disease connections: migraine and epilepsy.Lucas C.Migraine with aura.Rev Neurol (Paris). 2021;177(7):779-784. doi:10.1016/j.neurol.2021.07.010Spencer D.Auras are frequent in patients with generalized epilepsy.Epilepsy Curr. 2015;15(2):75-77. doi:10.5698/1535-7597-15.2.75International Headache Society Classification ICHD-3.Migraine-aura triggered seizure.Sforza G, Ruscitto C, Moavero R, et al.Case report: migralepsy: the two-faced Janus of neurology.Front Neurol. 2021;12:711858. doi:10.3389/fneur.2021.711858Keezer MR, Bauer PR, Ferrari MD, Sander JW.The comorbid relationship between migraine and epilepsy: a systematic review and meta-analysis.Eur J Neurol. 2015;22(7):1038-1047. doi:10.1111/ene.12612Spillane J, Kullmann DM, Hanna MG.Genetic neurological channelopathies: molecular genetics and clinical phenotypes.J Neurol Neurosurg Psychiatry. 2016;87(1):37-48. doi:10.1136/jnnp-2015-311233Liao J, Tian X, Wang H, Xiao Z.Epilepsy and migraine-are they comorbidity?Genes Dis. 2018;5(2):112-118. doi:10.1016/j.gendis.2018.04.007Mirmosayyeb O, Shaygannejad V, Ghajarzadeh M.Comparison of psychological difficulties in patients with migraine and epilepsy using PARADISE-24 questionnaire.J Multidiscip Healthc. 2020;13:609-613. doi:10.2147/JMDH.S260056Loder E, Burch R, Rizzoli P.The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines.Headache.2012;52(6):930-945. doi:10.1111/j.1526-4610.2012.02185.x Note to copy editor: This is the most current clinical guideline, so appropriate to cite.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mantegazza M, Cestèle S.Pathophysiological mechanisms of migraine and epilepsy: Similarities and differences.Neurosci Lett. 2018;667:92-102. doi:10.1016/j.neulet.2017.11.025Auffenberg E, Hedrich UB, Barbieri R, et al.Hyperexcitable interneurons trigger cortical spreading depression in an Scn1a migraine model.J Clin Invest. 2021;131(21):e142202. doi:10.1172/JCI142202National Institute of Neurological Disorders and Stroke.Headache: hope through research.National Institute of Neurological Disorders and Stroke.The epilepsies: hope through research.American Migraine Foundation.The timeline of a migraine attackKim DW, Lee SK.Headache and epilepsy.J Epilepsy Res. 2017;7(1):7-15. doi:10.14581/jer.17002American Brain Foundation.Disease connections: migraine and epilepsy.Lucas C.Migraine with aura.Rev Neurol (Paris). 2021;177(7):779-784. doi:10.1016/j.neurol.2021.07.010Spencer D.Auras are frequent in patients with generalized epilepsy.Epilepsy Curr. 2015;15(2):75-77. doi:10.5698/1535-7597-15.2.75International Headache Society Classification ICHD-3.Migraine-aura triggered seizure.Sforza G, Ruscitto C, Moavero R, et al.Case report: migralepsy: the two-faced Janus of neurology.Front Neurol. 2021;12:711858. doi:10.3389/fneur.2021.711858Keezer MR, Bauer PR, Ferrari MD, Sander JW.The comorbid relationship between migraine and epilepsy: a systematic review and meta-analysis.Eur J Neurol. 2015;22(7):1038-1047. doi:10.1111/ene.12612Spillane J, Kullmann DM, Hanna MG.Genetic neurological channelopathies: molecular genetics and clinical phenotypes.J Neurol Neurosurg Psychiatry. 2016;87(1):37-48. doi:10.1136/jnnp-2015-311233Liao J, Tian X, Wang H, Xiao Z.Epilepsy and migraine-are they comorbidity?Genes Dis. 2018;5(2):112-118. doi:10.1016/j.gendis.2018.04.007Mirmosayyeb O, Shaygannejad V, Ghajarzadeh M.Comparison of psychological difficulties in patients with migraine and epilepsy using PARADISE-24 questionnaire.J Multidiscip Healthc. 2020;13:609-613. doi:10.2147/JMDH.S260056Loder E, Burch R, Rizzoli P.The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines.Headache.2012;52(6):930-945. doi:10.1111/j.1526-4610.2012.02185.x Note to copy editor: This is the most current clinical guideline, so appropriate to cite.
Mantegazza M, Cestèle S.Pathophysiological mechanisms of migraine and epilepsy: Similarities and differences.Neurosci Lett. 2018;667:92-102. doi:10.1016/j.neulet.2017.11.025
Auffenberg E, Hedrich UB, Barbieri R, et al.Hyperexcitable interneurons trigger cortical spreading depression in an Scn1a migraine model.J Clin Invest. 2021;131(21):e142202. doi:10.1172/JCI142202
National Institute of Neurological Disorders and Stroke.Headache: hope through research.
National Institute of Neurological Disorders and Stroke.The epilepsies: hope through research.
American Migraine Foundation.The timeline of a migraine attack
Kim DW, Lee SK.Headache and epilepsy.J Epilepsy Res. 2017;7(1):7-15. doi:10.14581/jer.17002
American Brain Foundation.Disease connections: migraine and epilepsy.
Lucas C.Migraine with aura.Rev Neurol (Paris). 2021;177(7):779-784. doi:10.1016/j.neurol.2021.07.010
Spencer D.Auras are frequent in patients with generalized epilepsy.Epilepsy Curr. 2015;15(2):75-77. doi:10.5698/1535-7597-15.2.75
International Headache Society Classification ICHD-3.Migraine-aura triggered seizure.
Sforza G, Ruscitto C, Moavero R, et al.Case report: migralepsy: the two-faced Janus of neurology.Front Neurol. 2021;12:711858. doi:10.3389/fneur.2021.711858
Keezer MR, Bauer PR, Ferrari MD, Sander JW.The comorbid relationship between migraine and epilepsy: a systematic review and meta-analysis.Eur J Neurol. 2015;22(7):1038-1047. doi:10.1111/ene.12612
Spillane J, Kullmann DM, Hanna MG.Genetic neurological channelopathies: molecular genetics and clinical phenotypes.J Neurol Neurosurg Psychiatry. 2016;87(1):37-48. doi:10.1136/jnnp-2015-311233
Liao J, Tian X, Wang H, Xiao Z.Epilepsy and migraine-are they comorbidity?Genes Dis. 2018;5(2):112-118. doi:10.1016/j.gendis.2018.04.007
Mirmosayyeb O, Shaygannejad V, Ghajarzadeh M.Comparison of psychological difficulties in patients with migraine and epilepsy using PARADISE-24 questionnaire.J Multidiscip Healthc. 2020;13:609-613. doi:10.2147/JMDH.S260056
Loder E, Burch R, Rizzoli P.The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines.Headache.2012;52(6):930-945. doi:10.1111/j.1526-4610.2012.02185.x Note to copy editor: This is the most current clinical guideline, so appropriate to cite.
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