Migraines and Seizures

Migraines and seizures have similar symptoms and signs.

• A migraine is a collection of neurological symptoms that usually includes a severe and throbbing headache.
• A seizure is a change in the brain’s electrical activity that may affect how a person acts or what they do for a short period. The most common seizure disorder is epilepsy.
• Migraine aura and seizure aura are both chronic neurological events that have some similar symptoms including:
  • Visual aura
  • Irritability
  • Nausea
  • Vomiting
  • Sensitivity to light and sound
• Migraine aura symptoms that do not occur with seizures also may include:
  • Talkativeness
  • Appetite changes
  • Water retention
  • Sleep disturbances
  • Dizziness
  • Numbness or tingling in the extremities or face.
• Symptoms of seizure aura that do not occur with migraine aura also may include a feeling of heaviness, depression, and an impending feeling of a seizure coming on.
• In general, migraines do not cause seizures and seizures do not cause migraines, however, many of the symptoms that occur before a migraine are similar to symptoms experienced before a seizure.
• People who have migraines are twice as likely to have seizures, and vice-versa.
• Migraine treatment includes medications, lifestyle changes, and alternative treatments.
• Seizure treatment includes medication, surgery, vagus nerve stimulation, and dietary therapy.

A migraine is a type of headache with symptoms like a severe and throbbing headache on one side of the head accompanied by nausea, vomiting, dizziness, visual disturbances, numbness or tingling in the extremities or face, sensitivity to light and sound, touch and smell.

Some people with migraines experience an aura before the head pain starts. Migraine aura symptoms include visual disturbances ocular migraine), water retention, problems sleeping, appetite changes, and irritability.

Migralepsy is an outdated term that comes from putting together the words “migraine” and “epilepsy.” Misdiagnosis between migraine and epilepsy is common because headaches that often accompany seizures (ictal headaches) can be similar to a migraine with aura.

Currently, researchers and doctors do not recognize “migralepsy” as a medical condition, but rather, as an epilepsy-migraine sequence (and less likely, a migraine-epilepsy sequence).

An ictal headache is a rare type of headache in people with epilepsy. An ictal headache has the same pounding, throbbing feeling as a typical migraine, but usually is caused by seizure activity.

A seizure is a change in the brain’s electrical activity. Chemical changes that occur in nerve cells may cause too much or too little activity in parts of the brain, which can lead to electrical surges in the brain that cause seizures. Seizures usually affect how a person acts or what they do for a short period. A seizure can range from being mild and barely noticeable to being completely incapacitating. A seizure may also cause a lapse in awareness, called an absence seizure. Nonepileptic seizures (also called nonepileptic events) look like seizures but are not caused by electrical brain activity as in epilepsy.

• A seizure is not an illness; it is a symptom of a disorder that affects the brain. The most common seizure disorder is epilepsy.
• Nonepileptic seizures (also called nonepileptic events) look like seizures but are not caused by electrical brain activity as in epilepsy.

Migraine aura and seizure aura have similar symptoms such as:

• Visual aura
• Irritability
• Nausea/vomiting
• Sensitivity to light and sound

Key differences between migraine aura and seizure aura include:

Migraine aura symptoms

• Talkativeness
• Appetite changes
• Water retention
• Sleep disturbances

Pre-aura prodrome is more common in people with migraines than in people with seizures. Following a migraine aura, a migraine headache can last from 4 to 72 hours. An atypical migraine, also called a common migraine or migraine without aura, is not preceded by an aura.

Seizure aura symptoms

• Feeling of heaviness
• Depression
• An impending feeling of a seizure coming on

Following a seizure aura, the seizure occurs and the post ictal headache is brief.

• Seizures usually do not cause migraines.
• Migraine headaches and seizures share many similar symptoms and often a person with one disorder will experience the other.
• Seizure auras have many of the same symptoms as migraine auras.
• Many people who suffer seizures have severe headaches after their seizures because they are misdiagnosed as migraines.

• In general, migraines do not cause seizures.
• Migraines and seizures are two different neurologic problems that have overlapping symptoms.
• Many of the symptoms that occur before a migraine are similar to symptoms experienced before a seizure.
• However, people who have migraines are twice as likely to have seizures, and vice-versa.
• The cause of this relationship is not understood, but there is a clear correlation between the two disorders.
• In some children, headaches are the only symptom of seizures and they may be misdiagnosed as migraines.

Migraine medication treatments and lifestyle changes

• Medications for acute migraine treatment include over-the-counter (OTC) pain relievers such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), and acetaminophen (Tylenol); and prescription medications such as triptans, ergot derivatives, and narcotic pain medications.
• Medications to prevent a migraine attack include antidepressants, anticonvulsants, beta-blockers, calcium channel blockers, and hormone therapy (in women whose migraines are linked to their menstrual cycle).
• Erenumab (Aimovig) is a monthly injection used to prevent migraine headaches. Erenumab is the first drug in a new class of drugs called calcitonin gene-related peptide receptor (CGRP-R) antagonists. Erenumab was approved by the FDA in 2018.
• Lifestyle changes for migraine headaches and triggers:
  • Avoid known migraine triggers
  • Maintain a healthy balanced diet
  • Get regular exercise
  • Limit caffeine and alcohol
  • Use stress reduction techniques such as Yoga and meditation.
• Biofeedback, acupuncture, and counseling may also help.

Seizure treatment

• Medication: anticonvulsants, sedatives, medicines for nerve pain
• Surgery: Laser interstitial thermal therapy (LiTT) is a minimally invasive surgery used in individuals with drug-resistant epilepsy whose seizures do not respond to medication. The procedure uses heat to remove the part of the brain where the seizures originate.
• Focal resection: This surgery removes the portion of the brain where seizures begin, and is effective only when seizures originate reliably from a single location in the brain.
• Hemispherectomy: This procedure involves the removal of almost all of one side of the brain. This is only used in a small number of individuals.
• Corpus callosotomy surgery: Unlike the other procedures, this does not remove the sections of the brain where seizures originate. This procedure cuts off the brain’s electrical communication between hemispheres, interrupting the seizure activity.
• Vagus nerve stimulation (VNS): this involves stimulation of the vagus nerve by placing a pacemaker device in the chest.
• Dietary therapy: ketogenic diet (high fat, low carbohydrate)