Why is migraine rarely, and not usually, the sole ictal epileptic manifestation?

  • Parisi P
  • 25


    Mendeley users who have this article in their library.
  • 59


    Citations of this article.


Purpose and methods: Migraine, with or without aura, affects from 10% to 14% of the population, and is as such one of the most common headache disorders. A unified hypothesis for the physiopathology of migraine and its relationship with epileptic migraine and migralepsy has yet to be formulated. Trigemino-vascular system (TVS) activation is believed to play a crucial role in the "pain phase" in migraine; cortical spreading depression (CSD) is considered to be the primary cause of TVS activation. On the basis of data in the literature, I would like to stress that TVS activation may originate at different cortical and subcortical levels. For example, as recently reported, an epileptic focus, originating and propagating along cortical non-eloquent/silent areas, through CSD, rarely causes TVS activation with migraine as the sole ictal epileptic manifestation. Results and conclusion: The multiple considerations that arise from this hypothesis, including the under-diagnosed ictal epileptic headache, are discussed; EEG (ictal and inter-ictal) recording with intermittent photic stimulation (IPS), according to the standardized international protocol, is strongly recommended in selected migraine populations. © 2009 British Epilepsy Association.

Author-supplied keywords

  • CSD
  • Cortical spreading depression
  • Epilepsy
  • Hemicrania epileptica
  • Ictal epileptic headache
  • Migraine
  • Trigemino-vascular theory

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free