Tamara Wilhite has cared for a relative with both migraines and seizures, as well as a child with migraines.
Similarities Between Migraines and Seizures
Migraines and seizures are both neurological disorders. Migraine headaches are not seizures, though someone having a seizure start can feel like they are having a migraine before it progresses to a seizure, and a few people suffer from both epileptic seizures and migraine headaches. After a migraine headache starts, the affected person may only be able to feel better after lying down in a dark room or even sleeping it off.
Seizures and migraines share some of the same triggers. Bright strobe lights can cause migraine headaches and seizures in those who are susceptible. Both migraines and seizures are thought to be caused by over-excitability in the brain, which flashing lights can trigger. Sleep deprivation and menstruation can trigger migraines, while they increase the risk of someone having a seizure.
Someone who has seizures has twice the average chance of having migraines as well. Why isn’t this common knowledge? Because anti-epileptic drugs often treat the underlying problems that cause migraines, so treating the epilepsy often resolves the migraines. However, epilepsy is rare among migraine sufferers. The greatest odds that someone suffers from both conditions are when migraines result from post-concussion syndrome and the related brain injury leaves someone with epilepsy.
Compounding the problem is how many types of seizures are often mistaken for migraine headaches due to the similar symptoms.
Types of Epilepsy Mistaken for Migraines
Occipital epilepsy can be mistaken for epilepsy. This type of seizure typically lasts less than a minute, whereas a migraine lasts anywhere from five minutes to an hour. Occipital epilepsy and migraines can cause someone to see multiple circular spots.
When someone sees brightly colored spots moving horizontally and increasing in size, it is a symptom of epilepsy. If the person has a migraine, the lights spread from a single point and leave behind a degree of blindness. Someone with aural effects with a migraine may see a kaleidoscope of color for several minutes before the field of vision closes in, giving them a warning that the pain is about to start.
An occipital lobe seizure can cause many of the symptoms of a migraine like blurred vision, visual disturbances and lack of awareness but without the headache pain a migraine would. However, most people who have migraines don’t have auras or colored visual disturbances. Those who do have visual disturbances sometimes smell, hear and feel things that are not present as well. Pins and needles sensations are common if this is the case. After a migraine with an aura, limb weakness periodically occurs.
Basilar migraine headaches can be mistaken for seizures, since it can cause confusion and a loss of consciousness. This type of migraine headache comes with tinnitus (ringing in the ears), dizziness, double vision, difficulty speaking, confusion and trouble moving. Seizures will be differentiated from this type of migraine when an EEG or video-EEG is performed.
An acute confusional migraine with its intense loss of awareness before the pain sets in can be mistaken for epilepsy. The confusion and awareness may occur seconds or minutes before the severe pain kicks in.
How Seizures Differ from Migraines
Seizures arise from brain damage, though the causes can range from a severe head trauma to high fever. Someone with seizures will develop the condition after the brain damage.
When someone has a seizure, headaches will often occur after the seizure has occurred. With migraines, the symptoms like confusion and visual auras will start shortly before or in conjunction with the headache.
The biggest differentiation between seizures and migraines is in brain activity. An EEG for someone suffering a seizure will show sharp waves and spikes, something not seen when you have a migraine headache.
When someone has migraine headaches, the alterations in brain patterns will only be seen when the migraine pain is felt. For someone with epilepsy, the abnormal brain wave patterns may be seen at other times without turning into a full seizure. In short, the EEG for a migraine sufferer is only abnormal when they have a migraine attack, while an epileptic’s EEG will show abnormalities at other times but show a distinct signature when they have a seizure.
Seizures are not triggered by some of the things that trigger migraines, such as aged cheeses, alcohol, meats with nitrates, MSG, low blood sugar, dehydration, fasting, strong smells, drugs to improve blood flow in the body, exercise, weather changes or birth control pills. High stress, sleep pattern disruptions and bright lights are triggers shared by both.
How Migraines Differ from Seizures
Someone debilitated by a migraine headache will be in serious pain but not unresponsive as someone with a grand petite seizure is, and someone with a migraine headache will not lose convulse like someone with grand mal seizures.
However, a severe migraine can cause someone to feel light headed and faint, which can be mistaken for a seizure. After the migraine, someone may feel confused, tired, moody or be extraordinarily sensitive to light and sound.
An extremely bad headache without any other symptoms like alternation of consciousness, dizziness, visual changes or EEG spikes is a migraine and cannot be a seizure.
Migraines may start in someone’s teens or twenties, but if someone is going to develop them, it will usually show up before the age of thirty. The incidence of migraines will peak in the thirties and forties.
Women are three times more likely to have migraine headaches, while there is no such gender bias for epilepsy. For women, migraines have a strong hormonal link. Migraine symptoms are less likely immediately before or during a woman’s period, correlating to a drop in estrogen.
Hormonal contraceptives help some women’s migraines while worsening others. Interestingly, migraines’ hormonal link causes many women to see them stop when they hit menopause. Migraines with an aura tend to become less frequent with age, though the migraine headaches without the aura may persist. However, migraine related vertigo becomes more common with age.
Migraines can last several days straight, though this should be investigated by a doctor. Seizures never not last this long, though someone may have multiple seizures in one day.
Preventive Agents for Migraine: Focus on the Antiepileptic Drugs
- Preventive Agents for Migraine: Focus on the Antiepileptic Drugs
A 2012 study by R. Shahien and K. Beiruti found that anti-epileptic drugs were able to work as preventatives for migraines.
Seizures and Headaches: They Don't Have to Go Together
- Seizures and Headaches: They Don't Have to Go Together | Epilepsy Foundation
Everyone has some kind of headache at one time or another. But if you have epilepsy, your chances of suffering with headaches are greater than average. Headaches may occur before seizures and are common after tonic-clonic seizures.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: Can you have an abnormal EEG and it still be diagnosed as a migraine? I was initially treated with Dilantin. I reacted badly too and since I have found total relief on Ajovy. Flashing lights, though, still elicit a very agitated response and I avoid whenever possible.
Answer: It isn't uncommon for people who have seizures to have severe headaches. In that regard, an abnormal EEG indicating seizures can indicate a risk factor for migraines.