Epilepsy and migraine in children: a focus on clinical syndromes and diagnostic pitfalls

Epilepsy and migraine are quite common neurological disorders in the worldwide population characterized by episodic, paroxysmal manifestations. A common etiopathogenetical basis has been hypothesized. Peri-ictal headache is present in the majority of the epileptic patients, however, it may be neglected by the patients themselves as seizures represent the predominant disabling symptom. Comorbidity between migraine and several types of epilepsies has been increasingly reported in childhood, however, diagnosis of migraine in children is far to be easy and several symptoms need to be interpreted from the child's behavior. Indeed, clinical manifestations of several epileptic syndromes may imitate migraine and, in contrast, non-epileptic syndromes may imitate epilepsy. According to the etiopathogenetical link between migraine and epilepsy, common therapeutic strategies can be tried in both. The main epileptic syndromes of childhood associated with migraine as well as clinical and therapeutic implications of the comorbidity in children will be focused in the present review.