Yang Yuting, Peng Xi, Chen Yangmei
Chongqing Medical University, Chongqing, 400010, China.
Acta Epileptol. 2023 Feb 1;5(1):3. doi: 10.1186/s42494-022-00112-1.
Migraine and epilepsy are both episodic disorders, with some overlapping symptoms, mechanisms and therapies. Clinically, there is a comorbid relationship between them. Some migraine patients may exhibit epileptic discharges by electroencephalogram (EEG) recording. Therefore, the two conditions are easily misdiagnosed.
We reported a 16-year-old female patient who was admitted to our hospital due to repeated headaches with disturbance of consciousness. Epileptic discharge was recorded by long-term EEG. The patient had been misdiagnosed as epilepsy, and had no response to anti-seizure medicines (ASMs). We revised her diagnosis and prescribed ibuprofen in her acute episode and prophylactic medicine, including flunarizine and amitriptyline in her interictal period. One week later, her headache disappeared.
This patient manifested with altered levels of consciousness during headache episodes, and the abnormal EEG results lead to the misdiagnosis as epilepsy. Clinicians should be cautious to the distinction between migraine and epilepsy.
偏头痛和癫痫均为发作性疾病，在某些症状、机制及治疗方法上存在重叠。临床上，二者存在共病关系。部分偏头痛患者通过脑电图（EEG）记录可能出现癫痫样放电。因此，这两种疾病容易被误诊。
我们报告了一名16岁女性患者，因反复头痛伴意识障碍入院。长期EEG记录到癫痫样放电。该患者曾被误诊为癫痫，对抗癫痫药物（ASMs）无反应。我们修正了诊断，在急性发作期给她开了布洛芬，在发作间期开了预防性药物，包括氟桂利嗪和阿米替林。一周后，她的头痛消失了。
该患者在头痛发作时出现意识水平改变，EEG异常结果导致误诊为癫痫。临床医生应谨慎区分偏头痛和癫痫。
