Possible interference between migrainous and epileptic mechanisms in intercalated attacks. Case report.

The possibility that epileptic seizures and classic migraine episodes may occur in the same patient is discussed. The probable relationship between the neurophysiological mechanisms which underlie both types of attacks has not yet been agreed upon. The case of a young man who suffered from classic migraine and who presented two convulsive epileptic attacks, preceded by visual aura is described. The EEG showed an epileptogenic occipito-temporal focus which corresponded to the region of the scotoma origin. A possible connection between scotoma in migraine and epileptic discharge is discussed. It is proposed that spreading depression, as the basis of the migraine prodomata, was preceded by a moment of intense neuronal excitation which changed the epileptic intercritical activity into a critical one.