Migraines and seizures are complex neurological conditions. While they have distinct primary symptoms, overlaps exist, leading to questions about their potential interactions. Understanding each condition provides clarity on this topic.
Understanding Migraines and Seizures
Migraines are throbbing headaches, often affecting one or both sides of the head. They frequently involve nausea, vomiting, and heightened sensitivity to light and sound. These episodes can last anywhere from four to 72 hours in adults, varying in frequency from rare occurrences to several times a week. Approximately 60% of people with migraine experience prodromal symptoms, like mood changes or fatigue, hours or days before the headache. Up to one-third of individuals with migraine experience an aura, which involves temporary sensory disturbances such as visual changes (e.g., flashing lights, zigzag lines) that typically precede or accompany the headache.
Seizures, in contrast, result from sudden, uncontrolled electrical activity in brain nerve cells. This activity can lead to temporary changes in awareness, muscle control, behavior, or sensations. Symptoms vary depending on the brain region affected and can include staring spells, jerking movements, or even a brief loss of consciousness. Seizures generally last from a few seconds to a few minutes; a seizure lasting longer than five minutes is considered a medical emergency. While seizures are the primary symptom of epilepsy, they can also be triggered by other factors like high fever, head injury, or certain medical conditions, meaning not everyone who experiences a seizure has epilepsy.
The Relationship Between Migraines and Seizures
A migraine can cause a seizure in a rare phenomenon known as migralepsy, or migraine aura-triggered seizure (ICD-10-CM code G43.309). In migralepsy, a seizure occurs during or immediately following a migraine aura, typically within one hour of the aura’s onset. This indicates a direct, though infrequent, causal link. Migralepsy symptoms can include visual disturbances, sensory changes, speech difficulties, and seizure activity like convulsions or loss of consciousness.
Beyond migralepsy, migraines and seizures share broader neurological connections. Both are considered episodic disorders. They can arise from neuronal hyperexcitability, where brain cells are overly responsive to stimuli. This shared underlying mechanism suggests that a brain susceptible to one condition might also be more prone to the other. For example, people with epilepsy are twice as likely to experience migraines than the general population, and conversely, those with migraines may have an increased risk of seizures.
Genetic factors also contribute to the relationship between migraines and seizures. Both disorders are considered hereditable conditions, and certain gene mutations are associated with an increased susceptibility to both. Studies suggest that a strong family history of seizure disorders can increase the likelihood of experiencing migraine with aura. While the exact genetic links are still under investigation, the presence of common genetic predispositions further highlights the interconnectedness of these two neurological conditions. Shared environmental factors, such as head injury, can also lead to brain hyperexcitability, potentially contributing to both conditions.
Distinguishing Between Episodes
Differentiating between a migraine and a seizure can be challenging due to overlapping symptoms, particularly those involving sensory changes or altered consciousness. However, distinct characteristics help distinguish them.
Migraine aura develops gradually over five to 20 minutes and can last up to an hour, involving visual disturbances like zigzag lines or flashing lights. In contrast, epileptic auras, which are seizure onset symptoms, have a more rapid onset and are shorter, lasting only a few minutes.
The headache associated with a migraine is a prominent feature, described as throbbing or pounding, and can intensify with physical activity. While seizures can also be followed by headaches, these “post-ictal” headaches occur after the seizure activity has concluded and may resemble migraine-like pain. Seizures, particularly generalized ones, involve involuntary muscle movements, jerking or stiffening of limbs, and can result in a complete loss of consciousness. Migraines, even those with aura, do not involve motor convulsions or a complete loss of awareness, though some forms can cause temporary weakness or speech difficulties.
The post-event state also differs. Following a seizure, individuals experience confusion, exhaustion, or drowsiness, known as the post-ictal phase, which can last minutes to hours. After a migraine, while fatigue and cognitive dysfunction are common, the profound confusion and disorientation seen post-seizure are absent.
When to Seek Medical Attention
Consult a healthcare professional if you experience symptoms suggestive of migraines or seizures, especially if they are new or changing. Seek medical attention for a severe headache that is new, worsening, or different from previous headaches. This includes headaches that appear suddenly, are accompanied by new neurological symptoms like speech difficulties, balance problems, or confusion.
Any suspected seizure activity warrants a medical evaluation. This is particularly true for a first-time seizure, a seizure lasting more than five minutes, or if seizures occur in rapid succession without full recovery between episodes. Additionally, if a seizure results in injury, difficulty breathing, or occurs in a pregnant individual or someone with diabetes, immediate medical help is necessary. A healthcare provider can accurately diagnose the condition and develop a suitable management plan.