Migraine aura-triggered seizure or headache associated with epilepsy? Clinical case

Abstract

Event Abstract Back to Event Migraine aura-triggered seizure or headache associated with epilepsy? Clinical case Paul Cedric C. Mbonda1* 1 Catholic University of Louvain, Rehabilitation, Belgium Background Migralepsy, defined as the evolution of a migraine attack to a seizure, is a complex and controversial nosological entity for some authors. Few cases have been described in the literature, some of which are questionable. Case description We report the case of a young 23 year old woman with a history of migraine lasting for 5 years and who has never had epileptic seizures, who presented 3 times at night vigils, some visual manifestations of migraine with aura which rapidly changing to a generalized tonic-clonic seizure. The cerebral MRI was normal, waking EEG was normal, but during sleep few spike-wave in central and parietal right areas were observed. After introduction of sodium valproate, we observed a total cessation of seizures, and a decrease in migraine attacks. Discussion A continuum between migraine and epilepsy, two conditions that can go interrelated due to changes in cortical excitability can be found at certain privileged observations. Diagnosis “migraine aura triggered seizure” was chosen because the patient meets the ICHD-III criteria. Conclusion In our own opinion, it is a case of migraine aura triggered seizure, but this rare entity whose diagnosis is difficult, remains a challenge for the clinician, who must make sense of things as much as possible. Keywords: Migraine, Aura, Seizure, Valproate