BACKGROUND: The concept of migralepsy refers to visual migraine auras that seemingly evolve into epileptic seizures. It was discussed controversially ever since and scientific proof for this entity is scarce. METHODS: We report two patients with visual aura fulfilling the diagnostic criteria for migralepsy. In both patients, habitual attacks were recorded during long-term video electroencephalography (EEG) monitoring. CASE RESULTS: Both patients demonstrated unilateral occipital EEG seizure patterns during their long-lasting visual aura, which eventually evolved into versive seizures. CONCLUSION: Here, we prove the epileptic origin of the visual auras, which have been misdiagnosed as migraine or migralepsy before. Additional evaluation should be considered in patients with visual aura and hints for an epileptic origin as occipital lobe epilepsy might be missed in patients diagnosed with migraine. Based on our patients, we suggest to challenge the concept of migralepsy in current classifications.
BACKGROUND: The concept of migralepsy refers to visual migraine auras that seemingly evolve into epileptic seizures. It was discussed controversially ever since and scientific proof for this entity is scarce. METHODS: We report two patients with visual aura fulfilling the diagnostic criteria for migralepsy. In both patients, habitual attacks were recorded during long-term video electroencephalography (EEG) monitoring. CASE RESULTS: Both patients demonstrated unilateral occipital EEG seizure patterns during their long-lasting visual aura, which eventually evolved into versive seizures. CONCLUSION: Here, we prove the epileptic origin of the visual auras, which have been misdiagnosed as migraine or migralepsy before. Additional evaluation should be considered in patients with visual aura and hints for an epileptic origin as occipital lobe epilepsy might be missed in patients diagnosed with migraine. Based on our patients, we suggest to challenge the concept of migralepsy in current classifications.
Authors: Prisca R Bauer; Else A Tolner; Mark R Keezer; Michel D Ferrari; Josemir W Sander Journal: Nat Rev Neurol Date: 2021-07-26 Impact factor: 42.937