Seizures and Migraines: The Connection Between The Two

Seizures and Migraines: The Connection Between The Two

Diagnosing Migraines

A migraine is a type of a headache that has different symptoms that are usually more intense than the more common tension headache.

To diagnose migraine headaches, your doctor will confirm the following information:

  1. You can answer yes to at least two of the following questions:
    • Does a headache appear just on one side?
    • Do you feel a pulse?
    • Is the pain moderate or severe?
    • When you exercise or display physical activity does it aggravate the pain, or is the pain so bad you have to avoid that activity?
  2. You have a headache with one or both of the following:
    • nausea or vomiting
    • sensitivity to light, sound, or odors
  3. You’ve had at least five of these headaches lasting four to 72 hours.
  4. The headaches aren’t caused by another disease or condition.

Less commonly, sights, sounds, or physical sensations accompany a migraine.

Risk Factors

Migraines are about three times more common in women than men.

Headaches, and migraines, in particular, are more common among people with epilepsy than among the general population. At least one study estimates that one in three people with epilepsy will experience migraine headaches.

A person with epilepsy who has close relatives with epilepsy is more likely to experience a migraine with aura than someone without such relatives. This suggests that there’s a shared genetic link creating susceptibility to the two conditions.

Other characteristics may increase the likelihood of a seizure associated with a migraine. These include the use of antiepileptic drugs and having high body mass index.

Can Migraines Lead to Seizures?

Scientists don’t completely understand the connection between migraines and seizures. It’s possible that an epileptic episode may have an effect on your migraines. The opposite can also be true. Migraines may have an effect on the appearance of seizures. Researchers haven’t ruled out that these conditions appear together by chance. They’re investigating the likelihood that the headaches and epilepsy both arise from the same underlying factor.

To analyze any possible connection, doctors look carefully at the timing of a migraine to note whether it appears:

  • before seizure episodes
  • during seizure episodes
  • after seizure episodes
  • between seizure episodes

If you have epilepsy, it’s possible to experience both a migraine and non-migraine headaches. Because of this, your doctor must consider your symptoms to determine whether your migraine and seizure are related.

Treatment

Common drugs used to treat an acute attack of migraine pain include ibuprofen, aspirin, and acetaminophen. If these drugs aren’t effective, you might be prescribed a number of alternatives, including a class of drugs known as triptans.

If your migraines persist, your doctor may prescribe other medications.

Whatever drug regimen you and your doctor choose, it’s important for you to know how to navigate a medication program and to understand what to expect. You should do the following:

  • Take medications exactly as prescribed.
  • Expect to start with a low dose and increase gradually until the drug is effective.
  • Understand that headaches probably won’t be eliminated altogether.
  • Wait for four to eight weeks for any significant benefit to occur.
  • Monitor the benefit that appears in the first two months. If a preventive drug provides marked relief, the improvement may continue to increase.
  • Maintain a diary that documents your drug use, the pattern of the headache pain, and the impact of the pain.
  • If the drug is successful for six to 12 months, your doctor may recommend gradually discontinuing the medication.

Migraine therapy also includes management of lifestyle factors. Relaxation and cognitive behavioral therapy have been shown to be useful in treating headaches, but research is continuing.

How Are Migraines Prevented?

The good news is that you may be able to avoid migraine pain. Prevention strategies are recommended if your migraine pain is frequent or severe and if every month, you have one of the following:

  • experience a headache that lasts at least six days
  • you experience a headache that impairs you for at least four days
  • a headache that severely impairs you for at least three days

You might be a candidate for prevention for less severe migraine pain if every month you have one of the following:

  • experience a headache for four or five days
  • you get a headache that impairs you on at least three days
  • a headache that severely impairs you for at least two days

An example of being “severely impaired” is being on bed rest.

There are several lifestyle habits that may increase the frequency of attacks.

You should do the following to help avoid migraines:

  • Avoid skipping meals.
  • Eat meals regularly.
  • Establish a regular sleep schedule.
  • Make sure you get enough sleep.
  • Take steps to avoid too much stress.
  • Limit your caffeine intake.
  • Make sure that you get enough exercise.
  • Lose weight if you’re overweight or obese.

Finding and testing medications to prevent migraine pain is complicated by the cost of clinical trials and the complex relationship between seizures and migraines. There’s no one strategy that’s the best. Trial and error is a reasonable approach for you and your doctor in the search for your best treatment option.

What Is the Outlook?

Migraine pain is most common in early and middle adulthood and declines substantially afterward. Both migraines and seizures can take a high toll on an individual. Researchers continue to examine these conditions alone and together. Promising research is focused on diagnosis, treatment, and the how our genetic background might affect each of these.

References

  • Originally posted in Healthline
  • Becker, W. J. Findlay, T., Moga, C., Scott, N. A., Harstall, C., & Taenzer, P. (2015, August). Guideline for primary care management of headache in adults. Canadian Family Physician, 61(8), 670–679
    ncbi.nlm.nih.gov/pmc/articles/PMC4541429/
  • Cianchetti, C. Pruna, D., & Ledda, M. (2013). Epileptic seizures & headache/migraine: A review of types of association and terminology. Seizure, 22, 679-685
    ncbi.nlm.nih.gov/pubmed/23831147
  • Cousins, S., Ridsdale, L., Goldstein, L. H., Noble, A.J., Moorey, S., & Seed, P. (2015, December). A pilot study of cognitive behavioural therapy and relaxation for migraine headache: A randomised controlled trial. Journal of Neurology, 262(12), 2764-2772
    ncbi.nlm.nih.gov/pmc/articles/PMC4655008/
  • Evans, R. W., Seifert, T., Kailasam, J., & Matthew, N. T. (2008). The use of questions to determine the presence of photophobia and phonophobia During Migraine. Headache, 48(3), 395-397
    ncbi.nlm.nih.gov/pubmed/17868350
  • IHS Classification ICHD-II
    ihs-classification.org/en/02_klassifikation/02_teil1/01.02.00_migraine.html
  • Jabbehdari, S., Hesami, O. and Chavoshnejad, M. (2015). Prevalence of Migraine Headache in Epileptic Patients. Acta Medica Iranica, 53(6), 373-375
    ncbi.nlm.nih.gov/pubmed/26069176
  • Keezer, M.R., Sisodiya, S.M., & Sander, J.W. (2016, January). Comorbidities of epilepsy: Current concepts and future perspectives [Abstract]. The Lancet Neurology, 15(1), 106-115
    thelancet.com/journals/laneur/article/PIIS1474-4422(15)00225-2/abstract
  • Lipton, R.B., Bigal, M.E., Diamond, M., Freitag, F., Reed, M.L., & Stewart, W.F. on behalf of the AMPP Advisory Group. (2007). Migraine prevalence, disease burden, and the need for preventive therapy. Neurology, 68(5), 343-349
    ncbi.nlm.nih.gov/pubmed/17261680
  • MacGregor, E. A., Frith, A., Ellis, J. Aspinall, L., & Hacksaw, A. (2006). Incidence of migraines relative to menstrual cycle phases of rising and falling estrogen [Abstract]. Neurology, 67(12), 2154-2158
    ncbi.nlm.nih.gov/pubmed/16971700
  • Mainieri, G., Cevoli, S., Giannini, G., Zummo, L., Leta, C. Broli, M., & Bisulli, F. (2015). Headache in epilepsy: Prevalence and clinical features. Journal of Headache and Pain, 16, 72
    ncbi.nlm.nih.gov/pubmed/26245188
  • Pryse-Phillips, W. E. M., Dodick D. W., Edmeads, J. G., & Gawel, M. J. (1998, July 14). Guidelines for the diagnosis and management of migraine in clinical practice. Canadian Medical Association Journal, 159(1), 47-54
    ncbi.nlm.nih.gov/pubmed/9145054
  • Rogawski, M. A. (2012). Migraine and epilepsy — shared mechanisms within the family of episodic disorders
    ncbi.nlm.nih.gov/books/NBK98193/
  • Silberstein, S. D., Holland, S., Freitag F., Dodick, D. W., Argoff, C., & Ashman E. (2012, April 24). Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 78(17), 1337-45
    ncbi.nlm.nih.gov/pubmed/22529202
  • Smitherman T. A., Burch, R., Sheikh, H. & Loder, E. (2013, March). The prevalence, impact, and treatment of migraine and severe headaches in the United States: A review of statistics from national surveillance studies. Headache, 53(3), 427-436
    ncbi.nlm.nih.gov/pubmed/23470015
  • Winawer, M. R., & Connors, R. (2013) Evidence for a shared genetic susceptibility to migraine and epilepsy. Epilepsia, 54(2), 288-95
    ncbi.nlm.nih.gov/pubmed/23294289

Leave a Reply

Your email address will not be published. Required fields are marked *