Migraine et épilepsie: symptômes cliniques communs, comorbidité et mécanismes physiopathologiques

Migraine and epilepsy appear as fundamentally different diseases at first sight. However, both of them are characterized by recurrent attacks of nervous system dysfunctions, with a return to baseline between attacks. They share some clinical characteristics such as trigger factors (visual stimuli, sleep deprivation, stress, menses, etc.), enhanced sensitivity for sensory input such as light and sound and transient neurological symptoms including visual, sensory or speech symptoms. The possible occurrence of migrainous headaches before, during some ictal phases of a partial seizure (hemicrania epileptica) or after any seizure (postictal headaches), and the precipitation of an epileptic attack by a typical migrainous aura (migralepsy) also illustrate the reciprocal influences between migraine and epilepsy. Moreover, the alterations of neuronal excitability observed in migraine patients emphasize the debate of a common pathogenic mechanism between the two diseases. The purpose of this review is to present the clinical and pathophysiological similarities between these two disorders.