Migraine and epilepsy have a lot in common. For example, there are genetic connections. Epilepsy drugs are often used to treat migraine. And patients with one disease are likely to have the other as well.
One interesting connection between migraine and epilepsy is the “cortical spreading depression” (CSD). CSD is a kind of electrical storm that passes through the brain of a migraine patient. It’s also been observed after a traumatic brain injury, and in patients with malignant strokes.
As you may have guessed, CSD has also been observed in patients with seizures. So – could we just target the CSD, and get rid of both the seizures (in some patients) and migraine attacks (in others)?
One of the tricks is that the CSD is not nearly as predictable in patients with epilepsy as it is in patients with migraine (although we still have a lot to learn about its role in both diseases). Does the CSD occur before the seizure, during, or after? Well – yes, it could be any of those three. So – is it a cause, or is it actually a protective measure? Sometimes it does seem that the CSD can put up a wall to stop the seizure in the brain. Other times, it seems to prepare the brain for the next seizure.
The brain seems to use the CSD in some interesting ways that we’re just beginning to understand. But some researchers of both migraine and epilepsy are hopeful that we may be able to use our growing knowledge of this “brain storm” to help the brain heal and avoid future attacks, whether they be migraine attacks or seizures. One treatment that is being studied and used today is vagus nerve stimulation, which may actually inhibit the CSD. It’s hopeful that more treatments will be developed for both diseases, and maybe the cortical spreading depression will be the common target.
For a more in-depth discussion, see Interplay between Cortical Spreading Depolarization and Seizures