Migraine Comorbidities: Epilepsy

Written by Jessica Puterbaugh | October 1, 2022

Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness.[1] Migraine and epilepsy are frequently described as highly comorbid conditions and both appear to have a genetic predisposition.[2] The risk of having migraine is significantly higher for those with epilepsy—with one study estimating that risk is up to twice as high as compared to those without epilepsy.[3]


Migraine shares some common features with epilepsy and both conditions are still not completely understood. While migraine attacks and seizures are both events related to the brain, how exactly they relate to each other is not known.[4] The aura before a migraine is similar to an aura before a seizure, and brain activity detected by an EEG may even be similarly abnormal during both a migraine attack and a seizure.[5] Like a migraine attack, seizures can be triggered by stress, fatigue, menstruation, and alcohol, but how these factors lead to neuronal hypersynchronous activity and the initiation of an attack is not understood.[6] It is also unclear why some individuals are susceptible to migraine and others to epileptic seizures, and in those susceptible to both migraine and seizures, why attacks manifest as one or the other at different times. [7]

In addition, epilepsy can be comorbid with mental health disorders such as depression and anxiety, and sleep disorders,[8] as can migraine.

Shared Symptoms

People with epilepsy may experience headaches before seizures, known as pre-ictal headaches, or during seizures, known as ictal headaches. A migraine can occur alongside or after an epileptic seizure.[9] Migraine attacks and seizures can have other overlapping symptoms such as:

  • Phantom smells
  • Visual disturbances
  • Speech disturbances
  • Numbness
  • Memory issues
  • Fatigue


There are several medications that are FDA-approved to treat both epilepsy and migraine. Some antiepileptic drugs such as valproate and topiramate have shown to be effective in preventing both migraine attacks and seizures.[10] Other medications like beta blockers and calcium channel blockers may also be effective. [11]

In addition to medication, avoiding known triggers and maintaining a healthy lifestyle can also be helpful.

  • Avoid drinking alcohol
  • Prioritize and maintain a healthy sleep schedule
  • Manage stress through mindfulness, meditation, and regular exercise
  • Eat a well-balanced diet and don’t skip meals
  • Avoid bright, flashing lights

Tell us! Do you have comorbid epilepsy and migraine? Can the same trigger sometimes bring on a migraine attack and sometimes cause a seizure for you? How do you manage these conditions?


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