A case of migraine misdiagnosed as epilepsy.

Background: Migraine and epilepsy are both episodic disorders, with some overlapping symptoms, mechanisms and therapies. Clinically, there is a comorbid relationship between them. Some migraine patients may exhibit epileptic discharges by electroencephalogram (EEG) recording. Therefore, the two conditions are easily misdiagnosed.

Case presentation: We reported a 16-year-old female patient who was admitted to our hospital due to repeated headaches with disturbance of consciousness. Epileptic discharge was recorded by long-term EEG. The patient had been misdiagnosed as epilepsy, and had no response to anti-seizure medicines (ASMs). We revised her diagnosis and prescribed ibuprofen in her acute episode and prophylactic medicine, including flunarizine and amitriptyline in her interictal period. One week later, her headache disappeared.

Conclusions: This patient manifested with altered levels of consciousness during headache episodes, and the abnormal EEG results lead to the misdiagnosis as epilepsy. Clinicians should be cautious to the distinction between migraine and epilepsy.