Treatment of migraine in a patient with epilepsy.

Epilepsy and migraine often occur concomitantly in the same patient. The cause may be found in the similar genetic and pathophysiological background of the two diseases that is manifested by an excessive tendency towards neuronal hyperexcitation. Migraine concomitant with epilepsy increases the risk of the patient developing drug-resistant epilepsy, depression and anxiety disorders, as well as significantly decreases his quality of life. Therefore, in such patients, it is important to introduce effective and safe antimigraine treatment. In prophylactic migraine therapy such agents are recommended as certain anti-epileptic medications, calcium channel blockers, β-blockers, antidepressants and antihypertensives, while in interim treatment, triptans, analgesics and non-steroidal anti-inflammatory medications are employed. The therapy should be individualized to meet the patient's needs and also be based on the analysis of drug interactions, profile of adverse effects of the medications and concomitant diseases.