Demographic and Clinical Features of Epilepsy Patients with Migraine: A Retrospective Study
Abstract number :
1.288
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2025
Submission ID :
28
Source :
www.aesnet.org
Presentation date :
12/6/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Gulbudin Muhammad, MD – University of Toledo
Hira Pervez, MD – University of Toledo
Fahham Asghar, MD – University of Toledo
Syed Owais, MD – University of Toledo
Naeem Mahfooz, MD – University of Toledo
Ajaz Sheikh, MD – University of Toledo
Imran Ali, MD – University of Toledo
Rationale: To report demographic and clinical characteristics of epilepsy patients with migraine, prevalent neurological disorders that often coexist, potentially sharing common pathophysiological mechanisms. Understanding this association can improve patient care and inform therapeutic strategies.
Methods: This retrospective study analyzed data from the epilepsy database at Toledo Hospital and ProMedica Neuroscience Center (2017–2024).
Results: Among 3192 epilepsy patients, 221(6.9%) had history of migraine. Mean age was 39.01±18.15 years; mean age of seizure onset was 22.83±18.42 years. 168(76%) patients were female. Ethnicity included white 153(69.2%), black 25(11.3%), Asian 1(0.5%), and other 27(12.2%). Depression was present in 94(42.5%), anxiety in 95(43.0%), and family history of epilepsy in 35(15.8%) and migraine in 2(0.9%). MRI abnormalities were observed in 46(40.3%) of 114 patients, primarily non-specific ischemic white matter changes in 7(6.1%). EEG abnormalities were noted in 38(17.2%) of 116 patients, with 18 showing epileptiform activity and 20 background slowing. Generalized epilepsy was diagnosed in 64(29.5%), focal epilepsy in 53(24.4%), combined type in 9(4.1%) and unclassified in 64(29.5%). Monotherapy was used in 101(45.7%), polytherapy in 71(32.1%), and 49(22.1%) received no medication. Levetiracetam was the most common 70(31.7%), followed by topiramate 43(19.5%). Compared to 2971 patients without migraine (mean age 38.28±23.71 years, seizure onset 27.20±22.84 years), those with migraine had a significantly lower age at seizure onset (p=0.014), more likely female (p< 0.001), had higher rates of depression (p< 0.001) and anxiety (p< 0.001), family history of epilepsy (p< 0.001), abnormal EEG (p=0.001), MRI abnormalities (p< 0.001), with white matter lesions (p=0.007). Significant differences were observed in ethnicity (p=0.021) and epilepsy types (p< 0.001), but not in family history of migraine (p=0.430), presence of aura (p=0.088), or use of monotherapy versus polytherapy (p=0.141).
Conclusions: This study shows the significant association of migraine with female predominance, psychiatric comorbidities, and abnormal imaging in epilepsy patients, highlighting the need for further research on shared pathophysiology.
Funding: NO FUNDING
Clinical Epilepsy