FREQUENCY OF MIGRAINE HEADACHE IN PATIENTS WITH EPILEPSY

Abstract

Background: Migraine and epilepsy are prevalent neurological disorders that often coexist, potentially due to shared pathophysiological mechanisms such as cortical hyperexcitability and neurotransmitter imbalances. Migraine headaches significantly impact quality of life and may contribute to the disease burden in epilepsy patients. Despite growing evidence of their association, the frequency of migraines in epilepsy patients remains underexplored in many populations. Identifying the prevalence of migraines among epilepsy patients is crucial for improving clinical management and optimizing treatment strategies.

Objective: To determine the frequency of migraine headaches in patients with epilepsy.

Methods: This prospective observational cross-sectional study was conducted at Pakistan Emirates Military Hospital from February 2024 to October 2024. A total of 385 patients diagnosed with epilepsy were included using simple random sampling. Patients aged 18 years or older, diagnosed with epilepsy based on clinical and diagnostic criteria, and providing informed consent were eligible. Those with other neurological disorders, psychiatric conditions, or chronic pain syndromes were excluded. Data on demographics, seizure characteristics, and migraine symptoms were collected using a structured questionnaire and confirmed through clinical evaluation based on the International Classification of Headache Disorders (ICHD-3) criteria. Statistical analysis was performed using SPSS version 26.0. Descriptive statistics, chi-square tests, and cross-tabulations were used to analyze associations between epilepsy characteristics and migraine prevalence.

Results: Out of 385 patients, 234 (60.77%) were male and 151 (39.22%) were female, with a mean age of 45.41 ± 1.14 years. Migraine was reported in 258 (67.01%) patients. Among them, 162 (62.8%) had episodic migraines, while 96 (37.2%) experienced chronic migraines. Generalized epilepsy was more strongly associated with migraines, with 173 (74.9%) cases compared to 85 (55.8%) in focal epilepsy. Gender differences in migraine prevalence were not statistically significant (p > 0.05). Patients on polytherapy reported a higher frequency of migraines than those on monotherapy.

Conclusion: Migraine headaches are highly prevalent among epilepsy patients, particularly those with generalized epilepsy. The findings emphasize the need for routine headache screening in epilepsy patients to ensure timely diagnosis and appropriate management. Future research should explore targeted treatment strategies addressing both conditions simultaneously.