Department of Neurology, Austin Health, Heidelberg, Australia.
J Clin Neurophysiol. 2012 Jun;29(3):244-9. doi: 10.1097/WNP.0b013e3182570fee.
There is evidence for comorbidity of migraine and epilepsy. We used transcranial magnetic stimulation (TMS) to assess cortical excitability in migraine compared with control subjects and patients with epilepsy.
Twenty-six patients drug-naive patients with newly diagnosed migraine were studied. These were compared with 19 healthy control subjects and 50 patients with new onset epilepsy. Motor threshold (MT) and responses to paired pulse stimulation at short (2, 5, 10, and 15 milliseconds) and long (50-400 milliseconds) interstimulus intervals (ISIs) were measured.
Compared with control subjects, cortical excitability was higher in migraine only at 250 milliseconds (P < 0.05; effect size 0.7), while in epilepsy, it was higher at 2, 5, 250, and 300 milliseconds. Compared with epilepsy, cortical excitability was lower in migraine only at 250 milliseconds (P < 0.05; effect size 0.6 compared with focal epilepsy and 1.1 compared with idiopathic generalized epilepsy [IGE]).
Cortical excitability increases in migraine suggesting the involvement of intracortical inhibitory circuits. This may be a common feature underlying some of the similarities observed in migraine and epilepsy.
偏头痛和癫痫共病的证据确凿。我们使用经颅磁刺激（TMS）来评估偏头痛患者与对照组和新诊断癫痫患者的皮质兴奋性。
研究了 26 例新诊断偏头痛且未服用药物的患者。将这些患者与 19 名健康对照者和 50 例新诊断癫痫患者进行比较。测量了运动阈值（MT）和短（2、5、10 和 15 毫秒）及长（50-400 毫秒）刺激间隔（ISIs）时的成对脉冲刺激反应。
与对照组相比，偏头痛患者的皮质兴奋性仅在 250 毫秒时更高（P<0.05；效应量为 0.7），而在癫痫患者中，在 2、5、250 和 300 毫秒时更高。与癫痫相比，偏头痛患者的皮质兴奋性仅在 250 毫秒时更低（P<0.05；与局灶性癫痫相比，效应量为 0.6，与特发性全面性癫痫相比为 1.1）。
偏头痛患者的皮质兴奋性增加，提示皮质内抑制回路的参与。这可能是偏头痛和癫痫之间一些相似性的共同特征。
