Migraine, Migralepsy and Basilar Migraine

  • Sheryl R. Haut
  • Olga Fishman
  • Richard B. Lipton
Reference work entry

Short Description

Both epilepsy and migraine are common chronic neurological disorders with episodic attacks (CDEA) (Haut et al. 2006). These disorders are the two leading reasons for outpatient visitation to a neurologist and they occur together in the same individual with surprising frequency (Ottman and Lipton 1994) ( Fig. 93-1). The sensory, motor, and cognitive features of migraine and epilepsy often overlap, creating challenges in differential diagnosis. Because the disorders are highly comorbid, an even greater challenge is rendering concomitant diagnoses by recognizing two distinct CDEAs in the same person.


Migraine With Aura Cortical Spreading Depression Migraine Aura Visual Aura Headache Classification Committee 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. American Academy of Neurology Quality Standards Subcommittee (1995) Practice parameter: the electroencephalogram in the evaluation of headache (summary statement). Report of the Quality Standards Subcommittee. Neurology 45:1411–1413Google Scholar
  2. Andermann F (1987) Clinical features of migraine-epilepsy syndrome. In: Andermann F, Lugaresi E (eds) Migraine and epilepsy. Butterworths, Boston, pp 3–30Google Scholar
  3. Beaumanoir A, Jekiel M (1987) Electrographic observations during attacks of classical migraine. In: Andermann F, Lugaresi E (eds) Migraine and epilepsy. Butterworths, Boston, pp 163–180Google Scholar
  4. Bickerstaff ER (1987) Migraine variants and complications. In: Blau JN (ed) Migraine: clinical and research aspects. Johns Hopkins University Press, BaltimoreGoogle Scholar
  5. Eriksen MK, Thomsen LL, Olesen J (2005) The visual aura rating scale (VARS) for migraine aura diagnosis. Cephalalgia 25(10):801–810CrossRefPubMedGoogle Scholar
  6. Hadjikhani N, Sanchez Del Rio M, Wu O, Schwartz D, Bakker D, Fischl B, Kwong KK, Cutrer FM, Rosen BR, Tootell RB, Sorensen AG, Moskowitz MA (2001) Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA 98(8):4687–4692CrossRefPubMedGoogle Scholar
  7. Haut S, Bigal M, Lipton RBL (2006) Chronic disorders with episodic manifestations: focus on epilepsy and migraine. Lancet Neurol 5(2):148–157CrossRefPubMedGoogle Scholar
  8. Headache Classification Committee (2004) The international classification of headache disorders, 2nd edn. Cephalalgia 24(Suppl 1):1–160CrossRefGoogle Scholar
  9. LaPlante P, Saint-Hilaire JM, Bouvier G (1983) Headache as an epileptic manifestation. Neurology 33:1493PubMedGoogle Scholar
  10. Lauritzen M (1994) Pathophysiology of the migraine aura. The spreading depression theory. Brain 117(Pt 1):199–210CrossRefPubMedGoogle Scholar
  11. Leao AAP (1944) Spreading depression of activity in cerebral cortex. J Neurophysiol 7:359–390Google Scholar
  12. Marks DA, Ehrenberg BL (1993) Migraine related seizures in adults with epilepsy, with EEG correlation. Neurology 43:2476–2483PubMedGoogle Scholar
  13. Olesen J, Friberg L, Skyhoj-Olsen T (1990) Timing and topography of cerebral blood flow, aura and headache during migraine attacks. Ann Neurol 28:791–798CrossRefPubMedGoogle Scholar
  14. Olesen J, Larsen B, Lauritzen M (1981) Focal hyperemia followed by spreading oligemia and impaired activation of RCBF in classic migraine. Ann Neurol 9:344–352CrossRefPubMedGoogle Scholar
  15. Ottman R, Lipton RB (1994) Comorbidity of migraine and epilepsy. Neurology 44(11):2105–2110PubMedGoogle Scholar
  16. Panayiotopoulos CP (1994) Elementary visual hallucinations in migraine and epilepsy. J Neurol Neurosurg Psychiatry 57:1371–1374CrossRefPubMedGoogle Scholar
  17. Panayiotopoulos CP (1999) Elementary visual hallucinations, blindness, and headache in idiopathic occipital epilepsy: differentiation from migraine. J Neurol Neurosurg Psychiatry 66:536–540CrossRefPubMedGoogle Scholar
  18. Rogawski M (2008) Common pathophysiologic mechanisms of migraine and epilepsy. Ann Neurol 65(6):709–714CrossRefGoogle Scholar
  19. Russell M, Olesen J (1996) A nosographic analysis of the migraine aura in a general population Brain 119(2):355–361CrossRefPubMedGoogle Scholar
  20. Sanchez-Del-Rio M, Reuter U, Moskowitz MA (2006) New insights into migraine pathophysiology. Curr Opin Neurol 19(3):294–298CrossRefPubMedGoogle Scholar
  21. Schachter SC, Ito M, Wannamaker BB, Rak I, Ruggles K, Matsuo F et al. (1998) Incidence of spikes and paroxysmal rhythmic events in overnight ambulatory computer-assisted EEGs of normal subjects: a multicenter study. J Clin Neurophysiol 15(3):251–255CrossRefPubMedGoogle Scholar
  22. Silberstein SD, Dodick D, Freitag F, Pearlman SH, Hahn SR, Scher AI, Lipton RB (2007) Pharmacological approaches to managing migraine and associated comorbidities – clinical considerations for monotherapy versus polytherapy. Headache 47(4):585–599CrossRefPubMedGoogle Scholar
  23. Silberstein SD, Lipton RB, Goadsby PJ (eds) (2002) Headache in clinical practice, 2nd edn. Martin Dunitz, London, pp 47–68Google Scholar
  24. Silberstein SD, Young WB (1995) Migraine aura and prodrome. Seminars Neurol 45:175–182CrossRefGoogle Scholar
  25. Spierings E (1996) Symptomatology and pathogenesis. In: Management of migraine. Butterworth-Heinemann, Boston, pp 7–19Google Scholar
  26. Stewart WF, Linet MS, Celentano DD, Van Natta M, Ziegler D (1991) Age- and sex-specific incidence rates of migraine with and without visual aura. Am J Epidemiol 134(10):1111–1120PubMedGoogle Scholar
  27. Syvertsen M, Helde G, Stovner LJ, Brodtkorb EJ (2007) Headaches add to the burden of epilepsy. Headache Pain 8(4):224–230CrossRefGoogle Scholar
  28. Velioğlu SK, Boz C, Ozmenoğlu M (2005) The impact of migraine on epilepsy: a prospective prognosis study. Cephalalgia 25(7):528–535CrossRefPubMedGoogle Scholar
  29. Velioğlu SK, Ozmenoglu M (1999) Migraine-related seizures in an epileptic population. Cephalalgia 19(797):801Google Scholar

Copyright information

© Springer-Verlag London Limited 2010

Authors and Affiliations

  • Sheryl R. Haut
    • 1
  • Olga Fishman
    • 1
  • Richard B. Lipton
    • 2
  1. 1.Department of NeurologyComprehensive Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of MedicineBronxUSA
  2. 2.Departments of Neurology and Epidemiology and Population HealthMontefiore Headache Center, Albert Einstein College of MedicineBronxUSA

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