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Migraine and Epilepsy: A Common Target?

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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.

Migraine and Epilepsy: A Common TargetOne 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

Silent Seizure with Headache?

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Unfortunately, seizures and headaches often go together. But what about silent seizure and headache?

Headaches commonly occur after a seizure, sometimes before or even during. Epilepsy may also increase your risk of other headache disorders, such as migraine.

A child in the parkSilent seizures usually refer to one of two things. First, it’s a somewhat outdated term for what we now call absence seizures. Many people are familiar with the older term, petit mal seizures. These are seizures commonly seen in children that last only a few seconds. The child blanks out but does not fall or convulse.

Silent seizure may also refer to seizures that can be seen by an EEG in the brain, but that produce no visible symptoms (although there is some evidence that this type of seizure may affect some brain function). (Read about silent seizure activity in autism)

That being said, having silent seizure with headache (whichever type of “silent seizure” you’re referring to) is not common, if we’re talking about headache as a symptom of the seizure. There should be no headache before, during, or after the seizure. If there is, it may be a sign that there has been a misdiagnosis.

It is common to see headache in another type of childhood epilepsy, called benign epilepsy of childhood with occipital paroxysms (BECOP). The symptoms of BECOP can vary, so you’ll need to discuss symptoms with the doctor and have an EEG done by an expert.

There are some cases where a headache may be the only symptom of a seizure. If you suspect this is the case, as always, an EEG will need to be done to confirm what’s happening in the brain.

So is there any case in which it could be common to have silent seizure with headache? It is possible to have a headache disorder along with absence seizures, for example. The headache attacks probably won’t come right along with the seizure, but may happen at any time.

As with most headaches with seizure, the epilepsy and the headache will be treated separately. For example, if you are diagnosed with migraine, you may take medication for migraine, and for epilepsy. However, in the case of migraine, some medications for epilepsy are used as migraine preventatives. You may be able to take the same medication to treat both, even though you’re treating two different things.

It is very important to discuss your symptoms with your doctor, and keep an eye on when headaches and seizures happen, and what other symptoms may be present.

For more information, read Seizures and Headaches: They Don’t Have to Go Together. Also see Migralepsy Symptoms.

Child Migraine and Gluten

Child Migraine: A Sign of Celiac Disease?

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Although many people who do not have celiac disease have still found relief from their migraine attacks from a gluten free diet, a recent study suggests that migraine attacks may actually be a sign of celiac disease in children.

Celiac disease is an immune reaction to to eating gluten, a protein in wheat, barley and rye. It is diagnosed by blood tests and endoscopy, a method to check the tissue of the small intestine.

However, there are early indications of celiac that should tell doctors that these tests should be done. Although there are sometimes few or no symptoms, most commonly people with celiac experience digestive problems. In children, this may show itself as stomach pain and may lead to developmental problems.

Of course, stomach pain may also be a sign of abdominal migraine in children. In the case of celiac, though, the pain will typically strike after eating.

Child Migraine and GlutenIn a 2013 study, researchers found that neurological symptoms may also be an early sign of migraine. A third of the children had neurological symptoms, and the most common was headache and/or migraine.

The full list, most common first:

  • Migraine/headache
  • attention-deficit/hyperactivity disorder
  • epileptic seizures
  • slowed mental development
  • cerebellar ataxia (a type of brain damage affecting motor skills)
  • behavioural disorders

Celiac disease can be very serious in children because of the way it affects their development. It is very important to catch it as early as possible.

There is good news for children with celiac and migraine. When the children went on a gluten-free diet, it helped with the migraine attacks. The same was the case with the epilepsy symptoms.

Although we don’t yet have a standard blood test for migraine, in children it may be wise to test for celiac disease, especially if there are additional reasons to suspect that it may be present.

Study: Celiac disease with neurologic manifestations in children.

Fainting and Migraine Revisited

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Some of you may remember the infographic from 2013 about fainting and migraine, a summary of tips for migraine patients.

We could say that there are at least three ways in which fainting is related to migraine:

  1. Migraine patients seem to be more likely to faint in general (that is, not necessarily during a migraine attack).
  2. A patient may actually faint during a migraine attack. Though not common, it does happen.
  3. Patients with certain types of headache disorders (including migraine) are more likely to have fainting spells.

Fainting and MigraineSome patients have headache and fainting spells, and it’s not possible to diagnose them with a specific type of migraine or headache. But patients with migraine with brainstem aura (formerly known as basilar migraine or basilar-type migraine) may experience vertigo or even fainting. In fact, this type of migraine was also known as “syncopal migraine”, the word syncopal refers to fainting spells.

Migraine attacks associated with fainting may in some cases be genetic.

If you or someone you care for experienced fainting spells along with migraine, it is important to do a little research:

  • First, are there any other family members who experience either fainting or migraine attacks, or both? Knowing this will give your doctor important clues as to your condition.
  • If you experience fainting and migraine, it is wise to see a specialist (a neurologist). The two may be related, but it is also easy to misdiagnose your condition. Also, if possible, you do want to get a specific diagnosis, not just “migraine”. What kind of migraine?
  • Sometimes, fainting spells and seizures (due to epilepsy) can be confused. Fainting does not always mean you remain motionless, and seizures are often not the violent ones we all hear about most often. Migraine and epilepsy are related disorders. Again, seeing a specialist will help rule out som serious conditions.

If you find you are feeling faint, or fainting, during migraine attacks, make note of this and other symptoms, and mention them to your doctor. Whether your fainting turns out to be migraine-related or not, there are steps you can take to improve your quality of life. But you do need to do your homework first, to get the best treatment possible.

Status Migrainosus – when the attack doesn’t stop (graphic)

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Status Migrainosus

A person with migraine without aura
has a severe debilitating migraine attack
which lasts longer than 3 days.
Even after temporary relief from medication,
the symptoms remain.


Misdiagnosis is frequent. You may have…

Always see a doctor if symptoms change
or are worse than ever.

Your doctor may recommend:

A few more resources:

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The articles on Headache and Migraine News are © 2004-2026 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.