MIGRAINE-LIKE SYMPTOMS TRIGGERED BY OCCIPITAL LOBE SEIZURES - RESPONSE TO SUMATRIPTAN

Background: The relationship of ictal and post-ictal cephalic pain to migraine remains debatable. We hereby report 2 patients whose post-ict al migraine-like symptoms ameliorated in response to oral sumatriptan. Methods: Two patients, a 27-year-old woman and 41-year-old man were r eferred for assessment of migraine of 10 years and 4 years duration, r espectively. The man described a recent episode of ''vacant stare'' an d the woman has sensitivity to bright colours and light. Neurological examination, visual field testing, CAT scan, MRI scan, and prolonged E EG recordings were accomplished for each patient. Results: The man had a spontaneous seizure with ictal discharge arising from the right occ ipital lobe. Bilateral occipital spikes, associated with palinopsia wa s triggered in the woman by photic stimulation. Both patients develope d post-ictal headaches with symptoms similar to their migraines. The s ymptoms subsided following treatment with oral sumatriptan. Conclusion : Migraine-like symptoms occurring following occipital lobe seizures m ay share similar pathophysiological substrates with idiopathic migrain e. Serotonergic mechanisms may be implicated.