Neurophysiological features in patients with migraine at risk for epilepsy

Abstract

Objective: to study the electrophysiological parameters of brain bioelectric activity and features of the autonomous nervous system assessing heart rate variability, sympathetic skin response, clinical and physiological tests depending on the lateralization of migraine pain syndrome in the right or left brain hemisphere in patients with epileptic electroencephalogram (EEG) signs and migraine.Material and methods. Thirty six patients with aura-free episodic migraine at risk of developing epilepsy and 9 age-matched healthy subjects were examined. All participants underwent EEG, clinical and physiological tests, assessment of heart rate variability and sympathetic skin response.Results. Patients with right-hemisphere migraine headache had signs of activated sympathetic nervous system at baseline level and during exercise, lower baseline EEG epileptiform activity and in provocative tests. In contrast to the subjects of this group, patients of other group featured with a more stable migraine pain syndrome in the left hemisphere tended to dominate with functional activity of the parasympathetic system such as increased trophotropic support during exercise, as well as greater magnitude of baseline epileptiform bioelectric activity and during load tests.Conclusion. Values of heart rate variability in combination with objective results of clinical and physiological assessment of the autonomous nervous system and electrophysiological parameters of brain bioelectric activity are reliable prognostic indicators for varying functional conditions in patients with episodic migraine.