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探讨偏头痛与特发性/遗传性癫痫之间的共同触发因素和潜在发病机制:一项多中心三级研究的启示。

Exploring shared triggers and potential etiopathogenesis between migraine and idiopathic/genetic epilepsy: Insights from a multicenter tertiary-based study.

机构信息

Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey.

Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Istanbul, Turkey.

出版信息

Clin Neurol Neurosurg. 2024 Feb;237:108146. doi: 10.1016/j.clineuro.2024.108146. Epub 2024 Feb 6.

Abstract

INTRODUCTION

Migraine and epilepsy are two episodic disorders that share common pathophysiological mechanisms. The aim of our research was to assess the possible shared etiopathogenesis by analyzing the relations of headache, and seizure triggers, based on information obtained from a national cohort surveying the headache characteristics of 809 patients who had been diagnosed with idiopathic/genetic epilepsy.

MATERIAL AND METHODS

Our study utilized data from a multi-center, nationwide investigation of headaches in 809 patients with idiopathic/genetic epilepsy. Out of these, 508 patients reported complaints related to any type of headache (333 Migraines, 175 Headaches of other types). In the initial phase of the study encompassing the entire sample of 809 epilepsy patients, differences in seizure triggers were assessed between the migraine group (n = 333) and the non-migraine group (n = 476). Additionally, the subsequent part of the study pertains to a subgroup of the entire patient group, namely those affected by all types of headaches (n = 508), and differences in headache triggers were assessed among migraine patients (n = 333) and those with other types of headaches (n = 175). Similar differences were observed between epilepsy patients with and without a family history of epilepsy.

RESULTS

The most frequently reported seizure triggers in all I/GE group (n = 809) were stress (23%), sleep deprivation (22%) and fatigue (18%), respectively. The most frequently reported headache triggers in migraine patients were stress (31%), sleep deprivation (28%), and noise (26%). The occurrence of menstruation-triggered seizures in individuals with migraine and I/GE was found to be considerably higher than those without migraine. The most common triggers for seizure and headache among the individuals with a positive family history of epilepsy were determined to be light stimuli and sleep deprivation.

CONCLUSION

In conclusion, our study provides valuable insights into the overlapping triggers including sleep patterns, stress levels, and menstrual cycles, etc. and potential shared etiology of migraine and I/GE. Recognizing these connections may facilitate the development of more precise therapeutic strategies and underscore the significance of adopting a holistic, multidisciplinary approach to the management of these intricate neurological conditions. Further research is essential to explore in greater depth the shared mechanisms underpinning these associations and their implications for clinical practice.

摘要

简介

偏头痛和癫痫是两种发作性疾病,它们具有共同的病理生理机制。我们的研究目的是通过分析基于 809 名被诊断为特发性/遗传性癫痫患者头痛特征的全国性队列调查中获得的信息,评估头痛和癫痫发作诱因之间可能存在的共同发病机制。

材料和方法

我们的研究利用了一项多中心、全国性的 809 例特发性/遗传性癫痫患者头痛调查的数据。其中,508 名患者报告了任何类型头痛的相关症状(333 例偏头痛,175 例其他类型头痛)。在包括 809 例癫痫患者的整个样本的初始阶段,我们评估了偏头痛组(n=333)和非偏头痛组(n=476)之间的癫痫发作诱因差异。此外,研究的后续部分涉及整个患者组的亚组,即所有类型头痛患者(n=508),并评估了偏头痛患者(n=333)和其他类型头痛患者(n=175)之间的头痛诱因差异。在有和没有癫痫家族史的癫痫患者中也观察到了类似的差异。

结果

在所有 I/GE 组(n=809)中,最常见的癫痫发作诱因分别为压力(23%)、睡眠剥夺(22%)和疲劳(18%)。在偏头痛患者中,最常见的头痛诱因分别为压力(31%)、睡眠剥夺(28%)和噪音(26%)。偏头痛患者和 I/GE 患者中,与月经相关的癫痫发作发生率明显高于无偏头痛患者。有癫痫家族史的个体中,癫痫和头痛最常见的诱因是光刺激和睡眠剥夺。

结论

总之,我们的研究提供了关于偏头痛和 I/GE 重叠诱因的宝贵见解,包括睡眠模式、压力水平和月经周期等,以及它们潜在的共同病因。认识到这些联系可能有助于制定更精确的治疗策略,并强调采用整体、多学科方法来管理这些复杂的神经疾病的重要性。需要进一步研究来更深入地探讨这些关联背后的共同机制及其对临床实践的影响。

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