From migraine to epilepsy: a threshold mechanism?

A 67-year-old man complained of a transient blurring of vision in his right visual field lasting 30 min followed by headache. Two weeks later, the visual disturbance changed its pattern; it was described as the occurrence of brown round-shaped images in the right visual field spinning and turning for few seconds. This evolution from visual aura to visual seizures, with video-EEG correlation, supports the hypothesis of modification in threshold of cortical hyperexcitability from migraine to epilepsy.