The therapeutic link between migraine and epilepsy: case report and literature review

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Huang Iraj

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Abstract

The link between migraine and epilepsy and other transient diseases is well known, but the mechanism involved is
controversial. Similarly, although the role of maintenance opioids in preventing migraine and related individuals is
well known, there are few reports on the preventive use of opioids to prevent migraine and epilepsy (migraine).
Here, I provide detailed information on a patient with intractable migraine who responded well to the daily
scheduled opioids and eventually relieved headaches and seizures completely after a high dose of oxycodone.
Betty (pseudonym) was first discovered in 2007 at the age of 61. She complained of migraines, backaches and
headaches, accompanied by nocturnal paralysis of the upper limbs, suggesting carpal tunnel syndrome. The
headache on the right side began in 1999 with photophobia and nausea. Initially she received gabapentin and then
valproate, but the high-dose medication did not provide a significant relief. However, according to the headache
diary she kept in my office, her response to topiramate significantly reduced the severity of the headache, although
she occasionally continued to relapse. Nervous system examination and brain CT were normal. After that, the
headache improved after taking hydrocodone and triptan and topiramate. However, in the end, she received daily
opioid treatment with oxycodone to treat migraines.Gradually increase the dose to completely relieve the headache.
She had to gradually increase the dose to 30 mg, 3 times a day, 2 tablets each time. Surprisingly, not only the
headache stopped at this high dose, but the intermittent seizures she had recently suffered from also stopped. The
seizures she experienced before usually occurred at the end of a long-term migraine. I saw Betty at a social
gathering saying that headaches and epilepsy were back because she happened to be unable to find a doctor to
prescribe oxycodone. Therefore, this case study is similar to the five other migraine cases reported in a recent
article. Using the above therapies can completely relieve headaches and epilepsy.

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