COMORBIDITY OF MIGRAINE AND EPILEPSY

We investigated comorbidity of migraine and epilepsy by using informat ion from structured telephone interviews with 1,948 adult probands wit h epilepsy and 1,411 of their parents and siblings. Epilepsy was defin ed as a lifetime history of two or more unprovoked seizures, and migra ine as severe headaches with two or more of the following symptoms: un ilateral pain, throbbing pain, visual aura, or nausea. Cumulative inci dence of migraine to age 40 was 24% in probands with epilepsy, 23% in relatives with epilepsy, and 12% in relatives without epilepsy. Using Cox proportional hazards analysis to control for years at risk and gen der, the rate ratio for migraine was 2.4 (95% CI, 2.02 to 2.89) among probands and 2.4 (1.58 to 3.79) among relatives with epilepsy in compa rison with relatives without epilepsy. Migraine risk was highest in pr obands with epilepsy due to head trauma, but it was significantly high er in every subgroup of probands than in unaffected relatives when pro bands were stratified by seizure type, age at onset, etiology of epile psy, and history of epilepsy in first-degree relatives. Age-specific i ncidence of migraine among probands was increased to a greater extent after onset of epilepsy than before, but it was also significantly inc reased more than 5 years before onset and 1 to 5 years before onset. T hese results indicate that migraine and epilepsy are strongly associat ed, independent of seizure type, etiology, age at onset, or family his tory of epilepsy.