Psychogenic nonepileptic seizure (PNES) patients reported having more frequent and longer-lasting migraines than patients diagnosed with epilepsy, in an observational study conducted in the United States.
Researchers questioned 29 patients with epilepsy and 43 PNES patients about their migraines and seizures through the use of standardized questionnaires and a standardized interview. All study participants were found in a clinician database of patients who had been evaluated in the Mayo Clinic epilepsy monitoring unit between 2008 and 2014. Their ages ranged from 20 years to 82 years. Patients who were diagnosed with both PNES and epilepsy were excluded from the research project.
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PNES patients reported having significantly more migraine attacks and longer-duration migraines (when untreated) than patients with epilepsy. Specifically, on average, PNES patients said they experienced 6.5 migraine attacks per month and migraines with a length of 39.5 hours, whereas patients with epilepsy said they had, on average, 3.8 migraine attacks per month and migraines lasting 27.3 hours. Another significant difference between the two groups of patients occurred in the numbers of nonvisual migraine aura symptoms reported. While 22 of the PNES patients (78.6%) reported experiencing such symptoms, 7 of the epilepsy patients (46.7%) reported having nonvisual aura symptoms (P = .033).
“Our study adds to the existing literature [on the relationship between PNES and migraine] by detailing specific migraine characteristics in patients with PNES,” wrote Morgan A. Shepard and colleagues. The researchers noted that PNES patients could have overreported the severity of their migraine symptoms and that a high level of somatization has been found in patients with PNES.
The results of this research project “justify the need for clinicians to assess PNES patients for the presence of migraine and when present, to treat them appropriately for migraine,” according to the researchers.
The study’s authors did not report any conflicts of interest.
Read the study in Seizure (doi: 10.1016/j.seizure.2015.12.006).