Co-morbidity of migraine and epilepsy: a review of clinical features

Migraine and epilepsy are common neurological conditions that often co-exist. There are some common symptoms and in some patients there may be a diagnostic problem. The purpose of this study was to review the literature on the co-morbidity of migraine and epilepsy, and to differentiate their clinical characteristics. A search in Medline using the terms ‘migraine and epilepsy’ was conducted to identify articles published during the period 1963–1999. Articles describing co-morbidity of epilepsy and migraine have been reviewed. In the absence of convulsive episodes or a clearly migrainous profile (especially in children), confusion is most likely in patients affected by transient blindness, paroxysmal abdominal pain, unseen nocturnal events and “basilar” symptoms. Electroencephalographic abnormalities and response to an anticonvulsant may not clarify diagnosis. Although clinicians generally have little difficulty, rarely more investigations may be required for some patients. An isolated, single electroencephalogram may not provide definitive data unless an event is captured during the recording. Clinicians, therefore, have to rely mainly on the interpretation of the patient's history and clinical presentation.