Prevalence of interictal migraine among patients with epilepsy

Abstract Background Migraine and epilepsy are common neurological disorders that share several pathophysiological mechanisms, including cortical hyperexcitability. Migraine is more frequent in patients with epilepsy than in the general population. This study aimed to determine the prevalence of interictal migraine among adults with epilepsy and evaluate its association with epilepsy characteristics and demographic factors. Results This cross-sectional study included 100 adult patients with epilepsy attending the neurology outpatient clinic at Kafrelsheikh university hospitals. Clinical evaluation, Electroencephalogram (EEG), brain MRI, and migraine assessment according to ICHD-3 criteria were performed. Only interictal migraine was included. Migraine was identified in 25% of patients, with migraine without aura being the most common subtype (76%). Migraine was significantly associated with female sex, earlier age at epilepsy onset, higher seizure frequency, longer epilepsy duration, drug-resistant epilepsy, multiple antiepileptic drug use, and focal epileptiform EEG abnormalities (all p < 0.05). Logistic regression identified female sex, earlier age at epilepsy onset, prolonged epilepsy duration, and drug-resistant epilepsy as independent predictors of migraine. Conclusion Interictal migraine is a frequent comorbidity in epilepsy, particularly among patients with more severe disease. Early recognition of migraine may improve the comprehensive management and quality of life of patients with epilepsy.