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What is Migralepsy: Causes, Symptoms, Treatment, Diet

What is Migralepsy?

When a seizure occurs during or within one hour of occurrence of migraine aura attack, it is termed migralepsy. It is also termed migraine-induced epilepsy as the migraine episode is thought to trigger the seizure.

The scientific community does not fully agree whether migralepsy is a different diagnosis.

According to a 2018 review, epilepsy and migraine can be hard to tell apart.(1) Both the conditions cause episodes or attacks and cause similar symptoms, which include:

It is different from seizure-induced headache or migraine, as it’s the migraine that causes seizure not the other way round.(2)

What Causes Migralepsy?

Migraine and seizures may be connected with a similar pattern of brain activity, but their exact relationship is not known.

According to a 2011 review of research, about 1 to 17 people with migraines also have epilepsy and also people with epilepsy have reported frequency of migraine episodes of 8.4 to 20%.(3)

During a seizure, massive waves of electrical activity passing through areas of the brain, that activate many neurons in sync.

During migraine, the brain experiences similar, slowly spreading waves of electrical activity. This can last for several minutes and found being associated with experiencing a migraine aura.

It is proposed by scientists that electrical waves in migraine episodes can lower the threshold for a seizure to occur. This means a person is more likely to experience a seizure.

Following factors might increase the risk of migralepsy:

  • Genes that affect neurons
  • Issues with magnesium metabolism
  • Abnormalities with the channels in the brain that transfer electrical charges

Symptoms of Migralepsy

According to ICHD-3, the following is the order in which migralepsy symptoms are experienced.

Migraine with Aura

  • It starts with a migraine episode with an aura. The aura happens for a minute or hour before the headache starts. Each symptom can last for an hour.
  • An aura can also happen during the headache.
  • Aura is the collection of neurological symptoms that usually come gradually. A person might experience all or just some of them.

Visual symptoms or visual aura: It is very common and a person might see a zigzag pattern or wavy lines near the point where eyes are focussing. It could spread or move across the field of vision over time.

Sensory symptoms: This is the second most common aura symptom. There might be a feeling of pins and needles or numbness.

  • Motor weakness and speech disturbances are less common aura symptoms. There is slowed speech and a feeling of inability to speak.
  • There are various subtypes of migraine with aura. A doctor can help identify what subtype a patient is experiencing.
  • Migralepsy is not associated with migraine episodes that do not come with aura.


In migralepsy, a seizure is experienced within one hour of having a migraine with aura.

During a seizure, involuntary movements are experienced for a short period. It can affect the whole body or a few parts. It can also affect the control over the bowel and bladder.

Sometimes the seizure may also lead to loss of consciousness.

The types of epileptic seizure include:

  • Absence seizure: This leads to staring into space or blinking rapidly.
  • Tonic-clonic seizure: It is also called grand mal seizure and is the most serious type of seizure.
  • Simple focal seizure: This might lead to twitching and lead to new smell or taste.
  • Complex focal seizures: This affects the ability to respond to questions or directions.
  • Secondary generalized seizure: This is when a person has a focal seizure followed by a generalized seizure.

Treatment of Migralepsy

Drugs and surgery that help with migraine and epilepsy can help with migralepsy as well.

Migraine Preventing Drugs

Certain migraine preventing drugs may help in preventing cortical spreading depression, which is a slow wave of electrical activity in the brain. This happens when a person experiences a migraine with aura.


If migralepsy doesn’t go away with medicines, opioids are prescribed by the doctor.

Opioids are medications prescribed for the treatment of mild to moderate pain.

A review suggested, opioids may have a strong preventive effect against migralepsy.(4)


If people with epilepsy do not respond to drug treatment, surgery is recommended.

Diet Recommendations

Diet can also play a role in reducing migralepsy episodes.

A ketogenic diet can help treat epilepsy.(5) It is high fat and low-carb diet that makes the body shift from using blood sugar as fuel instead of fats.

Studies show ketogenic diet may help reduce or eliminate seizures in children and adults with epilepsy.

If the seizures last for more than 5 minutes or if there is an injury due to a seizure, it is important to seek emergency help.

Before visiting a doctor it is important to write all that happened before, during, or after an episode. This would help the doctor diagnose and identify triggers.

Migraine and seizure, both are serious conditions. If you experience them independently or together, it is important to keep a record and seek medical help right away.

Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:June 30, 2021

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