Recently, Barbara L. Nye and Vijay M. Thadani in a literature review [Headache 2015 Mar] clarified the clinical, pathophysiological and genetic overlap of migraine and epilepsy, and the similarity in drug therapy. In addition, the patients in the psychological characteristics of the same common.
In 2012, we published two literature reviews to identify the relationship between psychosocial difficulties (PSD) and migraine and epilepsy. [J Headache Pain 2012 Nov; Epilepsy Behav 2012 Sep] In these reviews, we analyzed and analyzed the PSD based on the disability biological-psycho-social medical model approved by the WHO International Health Function and Physical and Mental Disorders Classification System (ICF). PSD includes psychological impairment, as well as restrictions on activities, participation and social interaction situations such as work, family life, education or leisure time. These difficulties may partly represent the symptoms of both diseases, some of which are environmental factors such as drugs, support and others’ attitudes.
We would like to discuss here is the similarity between migraine and epilepsy; the picture below shows a summary of PSD, which we classify migraine-specific PSD, epilepsy-specific PSD and overlap between them. Overall, 81 studies were reported to report 51 of the PSDs, of which 16 PSDs (approximately half of the PSDs in each disease) were shared by both.
Six of the PSDs found in migraine and epilepsy were discussed in our review: general emotional function (5% of all PSDs), quality of life (5.9%), anxiety (7%), Global operation or disability (7.8%) and depression and symptoms (10.3%).
What is needed separately is employment, since in the study of epilepsy, the definition of employment (ie, the difficulty of work-related tasks) is very wide, and in migraine research it is divided into two parts (shortened working hours And reduced efficiency), this type of discussion on employment is generally described separately, but if they are added together, they account for 5.6% of all PSDs.
As Nye and Thadani point out, there are still many outstanding questions about the relationship between migraine and epilepsy. We believe that clinicians and researchers should be aware of the similarities between epilepsy and migraine, and that treatment has a potential effect on these secondary end points. In the future study, the emphasis on these six elements, the identification and assessment of the impact of daily life on migraine and epilepsy patients may be an effective approach, and may be specific for this treatment, which can be due to pathophysiology, clinical and psychological The conditions imposed by the burden for a better understanding.
Depending on all the factors associated with the disease and affecting the patient’s function, the subsequent trial design will be more refined and allow a more complete understanding of the two diseases. A comprehensive solution to these difficult patients reporting outcome indicators may require researchers to evaluate the effects of PSD-specific treatment.
Source: Alberto Raggi, Matilde Leonardi, Domenico D’Amico, Flavio Villani, Rui Quintas (Institute of Neurology, C. Besta IRCCS Foundation, Italy).