Nesterovsky Yu E, Zavadenko N N
Pirogov Russian National Research Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(4):100-106. doi: 10.17116/jnevro201811841100-106.
Migraine and epilepsy represent prevalent chronic neurological disorders of childhood. Migraine and epilepsy comorbidity relies on the common pathophysiologic and genetic mechanisms of the paroxysmal disorders the similarity of their precipitating factors, clinical manifestations and therapeutic approaches. The problems of differential diagnosis of migraine and epilepsy are related to peculiarities of migraine manifestations in children. Some forms of epilepsy could be accompanied by cephalgic seizures. The diagnostic criteria of headaches in epileptic patients are presented. A number of genetic diseases accompanying by migraine and epilepsy could be a model for delineation of shared pathogenetic mechanisms of these paroxysmal disorders in which genetically determined channelopathies may play an important role. The efficacy of antiepileptic drugs has been proven as the prophylactic treatment of migraine in pediatric patients. The advantages of levetiracetam as the prophylactic treatment for migraine and epilepsy comorbidity in children are discussed.
偏头痛和癫痫是儿童期常见的慢性神经系统疾病。偏头痛与癫痫的共病依赖于发作性疾病的共同病理生理和遗传机制，以及它们诱发因素、临床表现和治疗方法的相似性。偏头痛和癫痫的鉴别诊断问题与儿童偏头痛表现的特殊性有关。某些形式的癫痫可能伴有头痛性发作。文中介绍了癫痫患者头痛的诊断标准。一些伴有偏头痛和癫痫的遗传疾病可作为描绘这些发作性疾病共同致病机制的模型，其中基因决定的离子通道病可能起重要作用。抗癫痫药物已被证实对儿童偏头痛有预防性治疗作用。文中讨论了左乙拉西坦作为儿童偏头痛与癫痫共病预防性治疗药物的优势。
