What is a Migraine Seizure or Migralepsy?

A Rare Migraine Complication that Can Be Misdiagnosed

Migraines can lead to seizures.
Migraines can lead to seizures.. Jose Luis Pelaez Inc/MNPhotoStudios/Getty Images

A migraine seizure is a seizure that is triggered by a migraine with aura. While the technical term for this migraine complication is called migraine-aura triggered seizure, it's also been referred to as migralepsy, and overall is a rare phenomenon.

Diagnosis of Migraine-Aura Triggered Seizure

According to the International Headache Society, a migraine-aura triggered seizure occurs in a patient with migraine with aura, not migraine without aura.

The seizure occurs during or within one hour of the migraine with aura. An aura often involves some sort of change in a person's vision, such as zigzagging lines, flashing lights, or a temporary blind spot. It can also involve other neurological disturbances, like language or sensory problems.

Misdiagnosing Seizures as Migraines

Some experts believe that migralepsy is often erroneously diagnosed when a person is really having a seizure followed by a migraine-like headache (not the other way around). To support this, experts note that migraine-like headaches are seen in about 10 to 40 percent of people in the postictal phase of a seizure -- the period of time after a seizure has occurred. Sometimes these postictal migraine-like headaches are associated with vomiting and sensitivity to light, which may make them even more likely to be mistaken for migraines. In addition, a postictal headache often occurs about 3 to 15 minutes after a seizure.

This is similar to many migraine headaches, which occur within that time frame after a migraine aura.

Furthermore, the visual disturbances of a migraine aura can be confused with an occipital seizure, which is a type of seizure that occurs at the back of the brain where nerves pathways that control vision are located.

So it can be difficult sometimes to determine the true sequence of events -- did the migraine trigger the seizure or did the seizure trigger the migraine attack?

This all being said, migraine auras are quite different from visual seizures -- this is why your neurologist will carefully ask you to describe your visual symptoms. By sorting out the specifics of what you saw and the precise timing of all your symptoms, your doctor should be able to tease them apart.

Bottom Line

Both migraines and seizures are disorders that affect the brain. The fact that some people have both migraines and seizures, and the tricky dilemma of differentiating them, suggests a possible shared biological or genetic basis. The good news is that migraine triggered seizures can be effectively treated -- it just may take some patience to get your diagnosis sorted out.

Sources:

Crepeau, A.Z. (2014). Migralepsy: a borderland of wavy lines. Current Neurology and Neuroscience Reports, Feb;14(2):427.

Davies, P.T.G. & Panayiotopoulos, C.P. (2011). Migraine triggered seizures and epilepsy triggered headache and migraine attacks: a need for re-assessment. The Journal of Headache and Pain. Jun; 12(3): 287–88.

Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(Suppl. 1): 1-160.

Headache Classification Committee of the International Headache Society. (2013). "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia, 33(9):629-808.

Panayiotopoulos, C.P. Visual phenomena and headache in occipital epilepsy: a review, a systematic study and differentiation from migraine. Epileptic Disorders, Dec;1(4):205-16.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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