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Migraine and Epilepsy: What Studies Show

Do migraine and epilepsy appear together? What a 1.5 million-person meta-analysis shows and does not show, and how to keep two clean records.

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Yes, migraine and epilepsy appear together more often than in people without the other condition. A 2015 meta-analysis with 1,548,967 people found migraine was 52 percent more common in people with epilepsy, and epilepsy 79 percent more common in people with migraine. That describes a shared appearance, not a cause. If you have both, you keep two separate diaries, such as the migraine program and the seizure program in Sam, where each program is a diary with its own record and its own doctor report.

This text gives the numbers and their limits. Then it covers what you note for each condition and which appointment gets which report. It will not help you tell an aura from a seizure. Your neurologist does that.

What the studies describe

A meta-analysis in the European Journal of Neurology from 2015 looked at ten population studies. Together they covered 1,548,967 people. The authors compared how often migraine appears in people with epilepsy, and epilepsy in people with migraine. This means the frequency over a whole lifetime.

  • Migraine was 52 percent more common in people with epilepsy than in people without epilepsy (ratio 1.52; 95 percent confidence interval 1.29 to 1.79).
  • Epilepsy was 79 percent more common in people with migraine than in people without migraine (ratio 1.79; confidence interval 1.43 to 2.25).

That describes a shared appearance. It says nothing about cause and effect. The authors also name weaknesses. Few studies used tested methods to identify the conditions. Other influences were handled unevenly. They call for better studies.

A 2018 review asks in its title whether the two are comorbid. It lists similarities and differences. A 2024 meta-analysis in Frontiers in Neurology found a similar picture: migraine was about 80 percent more common in people with epilepsy, and epilepsy about 80 percent more common in people with migraine.

For context, Epilepsy Action says epilepsy affects around 630,000 people in the UK, almost 1 in 100. The NHS says migraine affects 10 million people in the UK and is more likely in women than in men. What these numbers mean for you, no study can say.

Why the neurologist keeps the call

Both conditions belong to neurology, and in experience they can overlap. A 2021 review in the Revue Neurologique says the classification can become difficult this way. That applies especially to an aura with visual disturbances. Headache after a seizure is common, the review notes.

The International Headache Society also describes a rare event in its classification: a seizure occurs during or shortly after a migraine attack with aura. The comment adds that migraine-like headaches often appear in the period after a seizure.

For you this means: you do not have to decide, and your record does not decide either. Write what you experienced. When it was, how long it lasted, and in what order. Whether you were conscious and what others saw. If you are not sure what it was, write that too. Ask your clinic how it wants such events in your record. Headache after a seizure you note with the seizure and mention it.

Why two courses instead of one list

In daily life, both events are often called an "attack". In the record they need partly different details.

For migraine, a diary notes how strong and how long an attack was, what happened during it, what you ate or drank before, and which medicines you took. For a seizure, the details are the time of day, the duration, and what happened before, during and after. A witness can help with the answers, because some people do not remember the seizure itself.

If you write both in one column, the monthly numbers get hard to read. Five migraine days and one seizure are two different statements. Separate courses let each number stand on its own. Whether one clinic covers both or two clinics, that does not change.

What you note for migraine

  • Start and duration of the attack, even roughly: under four hours, up to a day, several days.
  • The strength: mild, moderate or severe.
  • Accompanying problems such as nausea, and sensitivity to light and noise.
  • Whether an aura came before.
  • Whether you took an acute medicine, with the name or class.
  • One line about what came before. That is your guess, not proof.

Once a month, look at the limitation. The MIDAS questionnaire counts on how many days of the last three months migraine limited work, household or leisure. For more, see migraine diagnosis: what now and headache calendar: what to include.

What you note for epilepsy

  • When the seizure was: date, time, day or night.
  • Which type it was, as your neurologist named it. If you do not know, write "unsure".
  • How long it lasted, roughly.
  • Whether you lost awareness and whether you injured yourself.
  • Whether someone saw the seizure. A witness can describe what happened.
  • A suspected trigger, for example little sleep. That is a guess, too.
  • For fixed daily doses: whether you took them.

More is in new with epilepsy: the first weeks and seizure diary: data for the doctor visit.

For both courses, two habits help. Enter on the same day, not three weeks later. And always use the same fields.

Two appointments, two reports

The migraine clinic typically asks how many days you had migraine and on how many of those you took an acute medicine. It also asks the duration and how much the attacks limited you. The epilepsy clinic typically asks the number of seizures, their type, and whether they happened at night or by day. With a fixed daily dose, it asks how the intake went.

An invented example, four weeks in autumn:

  • For migraine: "Migraine on 6 of 28 days, acute medicine on 4 of them. Two attacks lasted more than a day."
  • For epilepsy: "One seizure, at night, someone saw it. Of 28 doses I ticked 27."

You read out loud instead of remembering. In Sam, each report comes as a PDF from its own program, ready to show from the doctor report. If one clinic covers both, show both courses. To both appointments belongs your full medication list. What you take for what is your clinic's decision. For what else goes in the folder, see the doctor visit checklist for a chronic condition.

Emergency and first aid: where reliable rules stand

This text gives no rules for that. Reliable pages are the NHS and Epilepsy Action. Driving rules differ by country and, in the US, by state. In the UK the NHS says that after any type of seizure you must not drive and must tell the DVLA; discuss the details with your treating doctor. This is general information, not legal advice. The NHS says to call 999 if it is the person's first seizure, if a seizure lasts longer than is usual for that person (or more than five minutes if you do not know how long theirs usually last), if the person does not regain full consciousness or has several seizures without regaining consciousness in between, if they are seriously injured, or if they have difficulty breathing afterwards. Use your local emergency number (112 in the EU, 999 in the UK, 911 in the US). Sudden paralysis, speech problems or vision problems can be signs of a stroke and are also a reason to call emergency services.

Keep the two courses in Sam and take one report to each

Each program gives you its own PDF report for the appointment: the migraine course from the migraine program for one clinic, the seizure course from the seizure program for the other.

  • Instead of one shared list on paper or in a notes app: each condition has its own fields, so the monthly numbers stay readable separately.
  • Instead of Apple Health alone: sleep and heart rate variability sit next to your new entries, and for epilepsy also the resting heart rate.
  • Instead of memory: the reports name migraine days, seizures by type, and how many were at night.

There is no joint report, and each program starts only after a doctor has confirmed the condition.

Try Sam for free

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Sources

More on recording and taking it along

Frequently Asked Questions

How often do migraine and epilepsy appear together?+

A 2015 meta-analysis of ten population studies with 1,548,967 people found migraine was 52 percent more common in people with epilepsy, and epilepsy 79 percent more common in people with migraine, than in people without the other condition. The authors report weaknesses in how the conditions were identified.

Is there a connection between migraine and epilepsy?+

Studies describe a shared appearance, not a cause. A 2018 review asks in its title whether they are comorbid. A 2021 review calls the relationship multifaceted. What it means for you, no diary can decide. You discuss that with your neurologist.

Can I keep migraine and epilepsy in one diary?+

At the same place, yes; in the same list, better not. Your clinic asks partly different things for each. Keep two courses: for migraine attacks, start, strength, duration and acute medication; for seizures, for example type, awareness, witnesses and time of day.

Can an app decide whether it was migraine or a seizure?+

No. Sam does not make a diagnosis. The entries show what you experienced. Your neurologist makes the call. What helps them: when it was, how long it lasted, what came before, and whether someone saw it.

Which report do I take to which appointment?+

To the migraine clinic, the migraine course with migraine days and duration. To the epilepsy clinic, the seizure course with seizures by type and how many were at night, plus doses taken if you ticked them off. If one clinic covers both, show both. In Sam each program has its own doctor report as a PDF.

How do I keep migraine and epilepsy separate in Sam?+

Each condition has its own program in Sam, with its own course and its own doctor report as a PDF. When you start a program, you confirm that a doctor has confirmed the condition. There is no joint report.

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