What you Need to Know about Migraine And Seizures (Migralepsy)

Migralepsy is an older term that has been used to describe when a person has both migraine and epilepsy, says Strauss. The term was first used in a paper published in 1960 to describe a condition in which "ophthalmic migraine with perhaps nausea and vomiting was followed by symptoms characteristic of epilepsy," according to a paper published in the Journal of Headache Pain.

This type of seizure, which is triggered by a migraine attack with aura, is considered a rare but real complication of migraine, according to the International Headache Society (ICHD-3).

A Seizure Can Be Part of Epilepsy or Migraine

To better understand the connection between migraine and seizures, it's helpful to understand what a seizure is, says Strauss. She describes it as "a sudden surge in electrical activity within the brain."

Johns Hopkins Medicine defines a seizure as "a burst of uncontrolled electrical activity between brain cells (also called neurons or nerve cells) that causes temporary abnormalities in muscle tone or movements (stiffness, twitching, or limpness), behaviors, sensations, or states of awareness."

According to the Centers for Disease Control and Prevention, epilepsy is diagnosed when someone has had at least two unprovoked seizures.

There are many types of seizures, depending on where they occur in the brain

According to the CDC, there are two types of seizures. One is generalized seizures that affects both the sides of your brain and the other is focal seizures. These seizures occur in one area of your brain.

Strauss explains that symptoms will vary depending on the part of your brain that is affected.

It makes sense, for example, that if your brain controls language, it could mean that your speech may be different during the seizure. You might have difficulty speaking or speech. Strauss also suggests that visual symptoms could be caused by seizure occurring in the part of your brain that controls vision.

The seizure may start in one area of the brain, but it doesn't necessarily stay there. According to her, a seizure may start in one brain area and spread rapidly to others or all of it.

Strauss notes that people can experience seizures in many ways. You can feel a shift in your awareness, and others might notice you staring. She says you may be suffering from amnesia. This is when you are unable to remember or don't know that there has been any change in your environment.

The whole body may shake, which is called grand mal seizure. It's what many people associate with seizure. Strauss also says you can have shaking in just one arm, or one leg.

A Migraine Attack Can Cause a Person to Get a Seizure

Strauss says that while we don't know what causes a migraine or a seizure, it is possible for something to trigger both.

Strauss states that headaches may occur by themselves and not be connected to seizures. Or, headaches could be an occurrence before, during or after a seizure. According to Strauss, "We use terms such as 'preictal', which means before the seizure; 'ictal', which indicates during the seizure; and 'postictal', which signifies after the seizure.

The Epilepsy Foundation says that ictal and preictal headaches are rare, and rarely last very long. More headaches occur following a seizure. Postictal headaches are more common in epilepsy patients. A study of 372 people who attended an epilepsy clinic revealed that almost half of those surveyed had ever experienced them.

What is the cause?

Strauss states that if a patient is suffering migraines and not responding to treatment, they should take stock and look at their neurologic symptoms.

She says that a grand mal seizure is usually a seizure. However, it is difficult to know if it is a migraine or a seizure when it causes focal seizures, partial seizures, complex seizures, or other subtle, sub-par seizures.

According to Strauss there are some key differences that help doctors distinguish migraine headaches from seizures-related headaches.

The prodrome can be associated with migraines or seizures. Strauss explains that the prodrome indicates the possibility of a migraine. The prodrome is a warning sign that a migraine will occur.

Automatism suggests a seizure. Automatism is a term that describes involuntary movements. Strauss explains that this can be a chewing movement or an involuntary movement such as picking up lint from your clothes. It is possible to experience migraine-related automatisms, but they are not common.

Visual disturbances may differ between migraine and seizure. Strauss states that visual disturbances may occur during migraine or seizures. She says that visual disturbances in migraine are typically short-term and can be described by patients as "circumscribed colored scribbles" (that move from one side to the next). Strauss says visual disturbances of migraine are usually more gradual and occur over minutes to hours.

Seizure usually indicates memory loss. Strauss says that headaches can lead to confusion. However, if the individual can't recall the exact time the headache occurred, it could be a seizure. Migraine can also cause transient global amnesia (a temporary, sudden episode of memory loss).

The onset of headaches can differ between migraine and seizures. Strauss says that migraine pain is more common and can be felt gradually. However, seizure headaches are sudden and intense. Seizure is indicated by unusual tastes and smells. Strauss says that if a person experiences a headache with a peculiar smell, taste, or smell, it is likely to be a seizure. People will often describe unusual smells, such as bananas and burnt fire. Or they might taste metallic. She says it is usually something strangely noxious and nobody else in the vicinity is sensing it.

Can Hemiplegic Migraine Cause Seizures?

Strauss says that sporadic hemiplegic headache is an uncommon form of migraine with different genes. The National Organization for Rare Disorders has reported that this kind of migraine can cause alterations to consciousness in some individuals.

Although it is not known how common this migraine is, studies done in Denmark have shown that approximately 1 out 10,000 sufferers are affected.

A migraine of this nature can last for up to seven days. A hemiplegic headache is characterized by weakness of one side. It occurs just before, or during, the headache phase. MedlinePlus states that severe cases of hemiplegic headache can lead to confusion, behavioral or personality changes, seizure, paralysis, loss of memory, personality, or even death.

Sometimes patients are concerned whether or not they have seizures. Strauss says there's some overlap. She says, "We need to make sure we don't miss a seizure diagnosis; just because you're having headaches and have weakness in your head, it doesn't mean that you're suffering from hemiplegic or cyclic migraine."

Strauss explains that people with focal seizures, which affect the motor control centre in the brain, can experience weakness in either their leg or arm when they stop having seizure.

A electroencephalogram is the most effective way to tell the difference between hemiplegic and severe migraine.