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Migraine-related seizures in adults with epilepsy, with EEG correlation

Department of Neurosciences (Dr. Marks). UMDNJ—New Jersey Medical School, Newark, NJ; and the Department of Neurology (Dr. Ehrenberg), Tufts University School of Medicine, Boston. MA.

We studied the relationship between migraine and epilepsy in 395 adult seizure patients. Seventynine patients (20%) also had migraine syndrome, and 13 of these patients (3%) experienced seizures during or immediately following a migraine aura. Patients with catamenial epilepsy and patients with migraine with aura were at an increased risk for an association between these two disorders. In two patients, we recorded the entire sequence from migraine aura to partial seizure, and in both there were distinctive changes on the EEG during the migraine aura that preceded the onset of an electrographic complex partial seizure. Periodic lateralized epileptiform discharges were recorded in five other patients in close temporal relation to their migraine attacks. There was improved seizure control with combination antimigraine and antiepileptic drugs (AEDs) in six patients who failed to respond to AEDs alone.

Address correspondence and reprint requests to Dr. Bruce L. Ehrenberg. Department of Neurology, Tufts-New England Medical Center, 750 Washington Street #4, Boston, MA 02111.

Received February 2, 1993. Accepted for publication in final form May 25, 1993

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