Migraine Seizure: What to Know

Migraine is a neurological disorder characterized by severe headache pain, nausea, dizziness, and sensitivity to light and sound. Seizures happen when you have abnormal surges of electrical activity in the brain, potentially causing involuntary jerking, confusion, and sometimes loss of consciousness.

It’s possible to have both migraine and seizures. While headaches are commonly associated with seizures, confirmed cases of seizures triggered by migraine are rare. These are called migraine seizures, or migraine aura-triggered seizures.

Experts are divided on whether migraine seizures are a separate, diagnosable condition, or simply cases in which people have both migraine and epilepsy, which is a condition that often causes seizures.

“There are clearly reports of migraine and seizures," says Andreas Alexopoulos, MD, MPH, a staff physician at the Epilepsy Center of the Neurological Institute at Cleveland Clinic. “But that doesn’t mean that the migraine condition caused the seizure. In general, these people usually have both migraine and epilepsy.”

“I do not think there is strong enough evidence to suggest migraine can cause seizure,” said Joanna Galindo, MD, a pediatric neurologist at OHSU. “On the other hand, migraine can be a symptom for a small portion of patients with epilepsy.”

While it’s not currently known whether a migraine attack can trigger seizures, there may be several factors at play.

Brain Activity

Because the brain activity is similar, it’s possible that one might make the other more likely.

“The changes of the migraine in the brain interact with the changes of seizure in the brain and perhaps trigger this sequence from migraine attack to a seizure attack,” Dr. Alexopoulos says.

Brain Region

Visual auras can actually make it easy to misdiagnose a seizure for migraine and vice versa. “In a small portion of pediatric patients, particularly [those] with childhood occipital visual epilepsy, about 25 percent may describe positive visual phenomena like seeing colors,” says Galindo.

Genes

• CACNA1A
• ATP1A2
• SCN1A
• PRRT2

Shared Risk Factors

• Changes to your vision
• Numbness, tingling, or muscle weakness
• Sensitivity to touch and smell
• Ringing in your ears
• Difficulty speaking or concentrating

Seizure symptoms can vary from person to person, but often include:

• A temporary sense of confusion
• Stiff muscles
• Involuntary jerking of the arms and legs
• Loss of consciousness

People who have seizures may also experience a migraine aura. This aura is common in people who experience partial seizures, also called focal aware seizures.

• A feeling of impending doom or premonition
• A sense of déjà vu
• Changes to your vision, hearing, smell, and taste
• Sudden nausea

Here is a breakdown of the differences between the two.

People can have seizures without having epilepsy. Epilepsy is a seizure disorder that a healthcare professional will diagnose when someone has recurring seizures.

Migraine attacks and seizures share certain symptoms, risk factors, and even treatments. Yet the exact connection between migraine and epilepsy is still unknown, there are many theories.

Researchers believe that migraine and seizures both activate similar pathways in the brain, affecting blood flow, metabolic demand, and neurotransmitters. “This has been demonstrated in patients who experience auras preceding migraine and particular seizure types,” Galindo says.

Alexopoulos says both epilepsy and migraine are treatable conditions and there are ways to reduce both attacks.

Doctors will likely treat migraine seizures in the same way they would treat a person who has both migraine and epilepsy. Several drugs are available that can treat migraine, epilepsy, or both. The antiepileptic medication topiramate can treat symptoms of epilepsy while preventing migraine attacks.

You can also prevent symptoms of both conditions at home by doing that following.

• Get good sleep. Not enough sleep or interrupted sleep can trigger epileptic and migraine attacks.
• Keep a routine. A consistent schedule, especially when it comes to eating, can prevent attacks. Missing meals is a risk factor for both seizures and migraine.
• Relieve stress when possible. Stress relief isn't always easy to come by, but stress plays a huge role in both conditions, so it's important to try. Relaxation techniques, therapy, and biofeedback are ways to manage stress.
• Notice hormonal fluctuations. Hormones can trigger both conditions. Examples include changes during a menstrual cycle. Learn your patterns, because you may be able to receive preventive medicine around your period to prevent an attack.
• Ask about foods and nutrition. Certain nutrient deficiencies, like low magnesium, share links with increased excitability in the brain. This may contribute to seizures or migraine. You can add more magnesium-rich foods to your diet or reach out to a doctor to check your magnesium levels.
• Manage mood. Mood disorders like depression are common in people with migraine and epilepsy. Manage your mental health to regulate stress and sleep, and improve your overall well-being.

“If there is something different about the migraine you’re experiencing, or the seizure you’re experiencing [is different] from usual or typical episodes, you should reach out to a doctor and set up regular check-ins,” Alexopoulos says.

Galindo also stresses that you should see a doctor as soon as possible if your migraine symptoms are not responding to preventive or rescue medications, or if you have concerns about atypical auras.

If you have any concerns about migraine or epilepsy, or believe you might have the rare migraine-triggered seizures, reach out to a doctor for evaluation.

• Migraine seizures are defined as someone having a migraine aura and then an epileptic seizure within an hour of the aura.
• Migraine seizures are rare, and there’s controversy about whether migraine seizures are a separate diagnosable condition, or whether people experiencing migraine seizures simply have both conditions (migraine and epilepsy).
• Migraine and epilepsy have similar symptoms and risk factors, making it possible to misdiagnose one for the other.
• People who have one condition have a higher risk of developing the other, but both are highly treatable.