Borderlands of Migraine and Epilepsy

Background: The complex relationship between migraine and epilepsy has frequently been described to represent a clinical and electrographic borderland. These two conditions share clinical expressions such as paroxysmal and chronic nature, as well as semiology, particularly visual phenomenon. Objective: We aimed to review the current literature on the overlapping phenomena of migraine and epilepsy. Materials and Methods: We searched the PubMed for relevant literature and conducted a narrative review on migraine and epilepsy. Results: Migraine and epilepsy share a complex and pathophysiologically intriguing relationship. The International Classification of Headache Disorders, 3rd edition (ICHD-3) makes diagnostic provisions for migraine aura-triggered seizures (Subchapter 1.4.4) and headache attributed to epileptic seizure (Subchapter 7.6), the latter being further categorized as 7.6.1 Ictal epileptic headache, and 7.6.2 post-ictal headache. Neurological conditions such as certain channelopathies and epilepsy syndromes exhibit both conditions within their phenotypic spectrum, suggesting shared genetic and molecular underpinnings. Diagnostic confusion may arise, particularly between occipital epilepsy and the visual aura of migraine. Antiseizure medications may be effective for the treatment of migraines that occur in concert with epilepsy. Conclusions: Migraine and epilepsy share several clinical features and have intertwined genetic and molecular underpinnings, which may contribute to common pathogenesis. Electroencephalography may be useful as a diagnostic tool in selected cases.

Automated summary

Migraine and epilepsy exhibit a complex and pathophysiologically intriguing relationship, including shared clinical features and intertwined genetic and molecular underpinnings. The ICHD-3 provides diagnostic provisions for these two conditions, while neurological diseases may present both migraine and epilepsy, necessitating attention to diagnostic confusion and treatment approaches.