Migraine and Epilepsy

In the January issue of Epilepsia articles ahead of print, Doctors Winawer and colleagues from the Sergievsky Center at Columbia University, Department of Neurology, Columbia University, and the Epilepsy Phenome/Genome Project (EPGP) investigators present an important analysis that helps to answer whether migraine headaches and epilepsy have some type of shared genetic predisposition as both conditions occur together frequently. Seven hundred thirty patients aged 12 years and older with non-acquired focal epilepsy or generalized epilepsy enrolled in the EPGP study were examined for the prevalence of a history of migraine. Information on migraine without aura and migraine with aura was collected using a previously tested questionnaire. Because individuals often have both migraines with and without aura, the investigators looked at two non-overlapping groups of individuals with migraine: those who met migraine with aura in any of their headaches and those who did not, migraine without aura. Participants in the study were interviewed about the history of seizure disorders in family members who were not part of the study. They looked at the association of migraine in patients who had been enrolled in the study with a family history of seizures, in addition to relatives who had not, using statistical measures to control what, if any, their relationship exists between epilepsy and migraine.

The investigators found that the prevalence of a history of migraine with aura, but not migraine without aura, was increased in patients who had two or more additional affected first degree relatives. This connection supports the hypothesis that there is some type of genetic relationship between patients who have epilepsy and patients with migraine with auras.

This study is important because as many practicing clinicians know, many of the medications that are used for the treatment of epilepsy are now approved for the treatment of migraine headaches. Therefore, some type of connection between these two problems would belogical and this study points to a link. What that genetic link is at this moment is not yet known but it further underscores the fact that there is some clear, shared common genetic connection between individuals who have migraines with auras and individuals who have epilepsy. Clearly, this is one of those findings that we will hear much more about as further discoveries are made from the EPGP project, as well as other studies worldwide.0