Epidemiological studies have shown that the risk of migraine is approximately twice as great in adults with epilepsy compared to those without epilspsy.¹ The researchers hypothesized that children with migraine may have a higher risk of developing seizures and epilepsy.

The study, led by Dr. Petur Ludvigsson of the University hospital in Reykjavik, Iceland, and colleagues, identified 94 Icelandic children between 9 and 15 years of age who experienced a first unprovoked seizure and had newly diagnosed epilepsy. These children were matched for age and sex to 188 unrelated children without a history of seizures.

A structured interview was used to assess headache symptoms in children. Instead of using five or more migraine-like headaches to diagnose children with migraine, as outlined in the International Headache Society criteria, a diagnosis was made if the children had experienced two or more migraine-like headaches.^2,3 The most common visual symptoms (zigzag lines, heat waves, blurry vision, or loss of vision) were used to diagnose aura.⁴ Cases without visual symptoms were classified as migraine without aura.

Overall, children with migraine had a 3.7-fold increased risk for developing epilepsy. There was no increased risk in those with migraine without aura. It has been suggested elsewhere⁵ that migraine with aura and migraine without aura are different disorders, and the authors say these findings support this hypothesis.

They conclude by saying, “These findings need to be confirmed in other population-base studies. If confirmed, they may further illuminate mechanisms underlying migraine with aura and epilepsy.

References:
1. Ottman R, Lipton RB. Comorbidity of migraine and epilepsy. Neurology 1994;44:2105-2110.
2. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias, and facial pain. 2nd ed. Cephalalgia 2004;24(suppl 1):9-160.
3. Patel NV, et al. Prevalence and impact of migraine and probable migraine in a health plan. Neurology 2004;63:1432-1438.
4. Lee LH, Olness KN. Clinical and demographic characteristics of migraine in urban children. Headache 1997;37:269-276.
5. Russel MB, et al. Migraine without aura and migraine with aura are distinct clinical entities: a study of four hundred and eighty-four male and female migraineurs from the general population. Cephalalgia 1996;16:239-245.

Source:
Ludvigsson P, et al. Migraine with aura is a risk factor for unprovoked seizures in children. Ann Neurol 2006;59:210-213.