How Epilepsy May Worsen Migraines and What You Can Do

I’ve seen firsthand how living with a chronic neurological condition can reshape daily life. One of my close friends deals with both epilepsy and migraines, and the overlap between them has always puzzled us. Are they simply co-occurring, or is there a deeper neurological connection? After diving into current research and talking to specialists, it turns out the answer is more intertwined than many realize.

Understanding the Overlap Between Epilepsy and Migraines

Both epilepsy and migraines are neurological disorders that involve abnormal brain activity. Epilepsy is characterized by unprovoked seizures, while migraines are often described as severe headaches with sensory disturbances. What connects the two, though, goes beyond symptoms. Some experts now consider the two to be part of a shared “spectrum disorder” due to overlapping pathophysiology.

In clinical settings, this overlap is referred to as “migralepsy”, a condition where a migraine is followed by a seizure. While rare, it presents strong evidence of a neurological link. In fact, according to data published by NCBI, patients with epilepsy are more likely to experience migraines than the general population, suggesting a common susceptibility in brain excitability.

Shared Symptoms That Often Confuse Patients

• Visual auras or disturbances
• Nausea and vomiting
• Temporary loss of awareness
• Photophobia and phonophobia

I remember my friend once describing his migraine aura as a “slow-moving, pixelated shimmer” in his peripheral vision—oddly similar to what he sees just before a seizure. It’s this kind of shared symptomatology that makes differential diagnosis challenging for neurologists.

What Causes the Link? Exploring Brain Excitability

Both disorders appear to stem from an imbalance in brain excitability, often driven by fluctuations in neurotransmitters like glutamate and GABA. In epilepsy, this imbalance leads to sudden electrical discharges; in migraines, it may cause cortical spreading depression—a wave of nerve cell activity followed by suppression, believed to be behind visual auras and headache pain.

This connection is what makes the link between epilepsy and migraines more than just coincidental. According to Mayo Clinic, people with one of these conditions may share genetic mutations in ion channel genes, such as CACNA1A, that predispose them to both disorders.

Genetic and Family History Factors

Genetic predisposition plays a huge role. In families with a history of epilepsy, migraines with aura are often more prevalent. This correlation is particularly noted in certain epilepsy syndromes, like Juvenile Myoclonic Epilepsy, where patients report migraine symptoms either preceding or following seizure episodes.

If you’re curious about broader genetic implications and triggers, our dedicated guide on genetics and migraines dives deeper into hereditary patterns of migraine disorders.

When Migraine Leads to Seizure: Understanding Migralepsy

Migralepsy, also known as migraine-triggered seizure, is officially recognized under ICHD-3 (International Classification of Headache Disorders). It refers to seizures that occur during or within one hour after a migraine aura. Although rare, its documentation gives valuable insight into how interconnected migraine and seizure pathways might be.

One neurologist explained to us that this might result from the overexcitability of neurons during an intense migraine, which “tips” into seizure territory. It’s a complex dance of electrical impulses that the brain sometimes can’t regulate.

Distinguishing Migralepsy from Other Conditions

1. Migraine Aura Without Headache: Often mistaken as absence seizures.
2. Epileptic Aura Without Seizure: Resembles migraine onset but doesn’t evolve into headache.
3. Occipital Seizures: Can mimic migraine aura but follow a different clinical timeline.

Because of the diagnostic gray areas, patients who experience both migraines and epilepsy are advised to work closely with a neurologist experienced in dual diagnosis. You can also read our resource on how migraines are diagnosed to understand how neurologists rule out overlapping conditions.

Impact on Quality of Life: Living with Both Conditions

Having epilepsy alone is life-altering, but when migraines are added to the mix, it becomes a double burden. From light sensitivity and nausea to the unpredictability of seizures, people often struggle with employment, social isolation, and overall emotional health.

In my friend’s case, certain migraine triggers—like sleep deprivation or stress—not only increased his chance of a migraine but also lowered his seizure threshold. That’s why keeping a migraine and seizure diary became a pivotal part of his management plan. Our free resource on migraine diary guides can help you or your loved ones track potential overlap triggers.

For a broader understanding of how lifestyle factors tie into migraine development, especially if you’re balancing multiple comorbidities, refer to our comorbid migraine conditions page.

Treatment Strategies When Both Conditions Coexist

Managing both epilepsy and migraines requires a careful, often multidisciplinary approach. Because certain anti-seizure medications also provide migraine relief, neurologists often look for therapies that target both. For instance, valproate and topiramate are FDA-approved for epilepsy and have shown effectiveness in reducing migraine frequency as well.

However, these medications aren’t one-size-fits-all. Some individuals report adverse cognitive effects or mood changes. I recall my friend having to switch prescriptions three times before finding one that didn’t impact his daily focus or memory. Personalized medicine truly matters in these cases.

To explore broader options, our guide to prescription migraine treatments walks through medication classes, their interactions, and which are commonly used in comorbid scenarios.

Therapies That Show Promise

• Neurostimulation devices: Devices like Cefaly or Nerivio are gaining traction for drug-free migraine management. Check our top migraine relief devices guide for more info.
• CBT (Cognitive Behavioral Therapy): Especially helpful when anxiety or depression coexist with seizures or migraines. Learn more about CBT for migraine management.
• Biofeedback therapy: Helps improve awareness of physical signals and control stress-induced neurological responses.

Preventive Measures: Reducing Risk Factors

When I asked a neurologist what the best prevention strategy was, his answer was simple: “Consistency.” For individuals with both epilepsy and migraines, lifestyle regularity is key. Erratic sleep patterns, skipped meals, and stress can all become potent triggers for both conditions.

Daily Habits That Help

1. Maintain a structured sleep-wake cycle.
2. Eat meals at regular intervals to avoid drops in blood sugar.
3. Use migraine and seizure tracking apps. We’ve reviewed a few in our migraine tracking apps article.
4. Hydration and magnesium-rich foods can help. You can check our article on magnesium for migraine prevention.

It’s also worth exploring alternative and supportive therapies. Many of our readers have shared positive outcomes with yoga for migraine relief and acupuncture. These methods not only reduce pain frequency but also promote stress reduction, a known trigger for both seizures and migraines.

Communicating With Your Neurologist

One of the biggest lessons I learned watching someone live with both epilepsy and migraines is the importance of communication. Sometimes a medication that works well for seizures may trigger migraines, and vice versa. Having a provider who understands the intersection of both disorders is essential.

If you’re currently looking for a neurologist with a dual expertise, start by visiting our resource on how to find a migraine specialist. This ensures that your treatment plan considers the complexity of coexisting neurological conditions.

Additionally, many patients find value in bringing printed tracking logs to appointments, especially when patterns are unclear. Templates and tips for this are available in our migraine diary guide.

Final Note: Living With Dual Neurological Conditions

Balancing both epilepsy and migraines can be mentally and physically taxing, but knowledge, preparation, and support make a tremendous difference. From proper medical guidance to lifestyle consistency, it’s possible to manage both conditions and regain quality of life.

To explore more interconnected conditions, you can read our overview on migraine comorbidities. And remember, our main hub for comprehensive guidance is always available on the Migraines & Headaches main page.