Abstract Details

Title Flunarizine Therapy in Migralepsy

Topic Headache

Presentation(s) P01 - (-)

Poster/Presentation
Number 074

Objective

Background Migralepsy as defined by Lennox is a classic migraine attack which evolves into an epileptic seizure. The seizure may be triggered by a migraine aura. In this communication we describe a series of patients, who during the course of migraine headaches had seizures which responded to migraine prophylaxis therapy.

Design/Methods 37 out of 803 patients with migraine had seizures during the period of their headaches. These patients were seen at the Headache clinic in the Institute of Neurology during a 1 year period. These are patients who had seizures at different time periods after onset of headache and included patients without an aura as well. These patients were treated with medication as for migraine and results observed on follow up. Clinical examination, imaging & EEG were done on all these patients.

Results 8 of these 37 patients had seizures following a prolonged aura. In 29 patients the seizures marked the terminal phase of the migraine episode. Of these, 8 patients had no migraine aura. Of these 37 patients 17 had clonic jerks while 20 patients had prolonged loss of consciousness of not less than 10 minutes associated with tonic posturing in 4 of them. These patients were given prophylactic therapy with Flunarizine and/or Flunarizine and Propranolol. 21 patients responded with no occurrence of seizures during subsequent episodes of headache to Flunarizne alone while 10 more patients responded to a combination of Flunairzine and Propranolol. 6 patients did not respond and had to be given Topiramate to control these episodes.

Conclusions Flunarizine, either alone, or in combination with Propranolol, was effective in 83% of patients to control the occurrence of seizure during migraine episodes. This finding supports the view that Migralepsy is a part of the spectrum of Migraine headache.

Authors/Disclosures
Natarajan Visvanathan, MD, DM, FAAN PRESENTER	No disclosure on file
Murali Ramanathan, PhD (University At Buffalo)	The institution of Dr. Ramanathan has received research support from DoD. Dr. Ramanathan has received publishing royalties from a publication relating to health care.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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