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Despite more than 100 years of investigation, the association between epilepsy and migraine has yet to be fully understood.1–3 There are several possible explanations for the co-occurrence of these two disorders.2–4 First, since migraine and epilepsy are both relatively common, they may co-occur frequently by chance. Second, they may be mistaken for one another, as migraine and epilepsy—particularly partial seizures—have considerable overlap of clinical symptoms. Third, one may cause the other—migraine may trigger or evolve into a seizure (“migralepsy”)4 and seizures may cause post-ictal headache. Fourth, they may have a shared pathophysiology, such as ion channel dysfunction, that is not necessarily the result of shared genetic factors. Finally, migraine and epilepsy may have a shared genetic cause, a topic addressed in this issue of Neurology by Deprez et al., in their description of linkage of familial occipitotemporal lobe epilepsy and migraine with visual aura to chromosome 9q.5
There is strong evidence for the comorbidity of migraine and epilepsy2,6; risk of migraine has been found to be more than …
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