Children who have migraines with an aura have a significantly greater risk of developing epilepsy, researchers have found. They found no increased risk of seizures for children who had migraines without auras.

Migraine with an aura accounts for about 30% of all migraines. An association between migraine and epilepsy has been recognised for a long time. Adults with epilepsy have twice the risk of migraine than adults without epilepsy. The underlying causes of this link are still not clear.

The researchers studied a group of 94 children from Iceland, aged between 9 and 15 years. Of these, 56.4% had a diagnosis of epilepsy, and 43.6% had had a single seizure. These patients were compared with a group of 188 children without a history of seizures. Each child with epilepsy was matched for age and sex to two unrelated children in the comparison group. Researchers interviewed all the children for details of headache symptoms. They diagnosed migraine if the children had experienced two or more episodes of migraine-like headache. Visual symptoms (zigzag lines, heat waves, blurry vision, or loss of vision) were taken to indicate an aura.

Children who had migraines with an aura had a 8.1 times greater risk of developing epilepsy than those with other types of migraine or no migraine. Children who had migraines without aura had no significantly greater risk of developing epilepsy.

The results, published in Annals of Neurology in January 2006, suggest that migraines with and without auras are two different disorders. Migraine with aura is associated with the development of epilepsy: it's not clear whether it causes it or whether both disorders share an underlying cause. Dr W Allen Hauser of Columbia University, New York, said that it was clear that migraine developed before epilepsy, at least in children. Children with migraine headaches with aura are at increased risk of developing epilepsy; children with migraine headaches without aura are not.

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