Abstract:
Migraine and epilepsy are distinct neurological diseases with specific clinical features and underlying pathophysiological mechanisms. However, numerous studies have highlighted the complex and multifaceted relationships between the two conditions. The relationships between headache and epilepsy manifest themselves in different ways. Firstly, the clinical diagnosis of these disorders may be challenging in view of possible overlapping. While post-ictal headache is a frequent condition, ictal epileptic headache is a rare but challenging diagnosis. Both situations raise the question of the pathophysiological mechanism of headache triggered by seizures. Migraine aura and epilepsy can also exhibit overlapping symptoms leading to their misdiagnosis, in particular in the case of visual aura. Secondly, migraine with aura and epilepsy can occur as a co-morbid condition, particularly in familial hemiplegic migraine (FHM). From a pathophysiological perspective, the identification of genetic mutations in FHM has brought significant advances in the understanding of dysfunctions of neuronal networks leading to hyperexcitability. The purpose of this review is to present clinical situations encompassing headache and epilepsy that can be challenging in neurological practice and to discuss the underlying pathophysiological mechanism of such interactions.
摘要:
偏头痛和癫痫是不同的神经系统疾病,具有特定的临床特征和潜在的病理生理机制。然而,许多研究强调了这两个条件之间复杂和多方面的关系。头痛和癫痫之间的关系以不同的方式表现出来。首先,考虑到可能的重叠,这些疾病的临床诊断可能具有挑战性.虽然发作后头痛是一种常见的疾病,发作性癫痫性头痛是一种罕见但具有挑战性的诊断。两种情况都提出了由癫痫发作引发的头痛的病理生理机制的问题。偏头痛先兆和癫痫也可能表现出重叠的症状,导致误诊,特别是在视觉光环的情况下。其次,有先兆的偏头痛和癫痫可以作为一种共同的疾病发生,特别是家族性偏瘫性偏头痛(FHM)。从病理生理学的角度来看,对FHM基因突变的鉴定在对导致过度兴奋的神经元网络功能障碍的理解方面带来了重大进展。这篇综述的目的是介绍在神经学实践中可能具有挑战性的头痛和癫痫的临床情况,并讨论这种相互作用的潜在病理生理机制。