Symptoms Triggered by Occipital Lobe Seizures: Response to Sumatriptan
Ogunyemi and Dermot Adams
Background: The relationship of ictal and post-ictal
cephalic pain to migraine remains debatable. We hereby report
2 patients whose post-ictal migraine-like symptoms ameliorated
in response to oral sumatriptan. Methods: Two
patients, a 27-year-old woman and 41-year-old man were referred
for assessment of migraine of 10 years and 4 years duration,
respectively. The man described a recent episode of "vacant
stare" and the woman has sensitivity to bright colours and light.
Neurological examination, visual field testing, CAT scan, MRI
scan, and prolonged EEG recordings were accomplished for each
patient. Results: The man had a spontaneous seizure
with ictal discharge arising from the right occipital lobe.
Bilateral occipital spikes, associated with palinopsia was triggered
in the woman by photic stimulation. Both patients developed
post-ictal headaches with symptoms similar to their migraines.
The symptoms subsided following treatment with oral sumatriptan.
Conclusion: Migraine-like symptoms occurring following
occipital lobe seizures may share similar pathophysiological
substrates with idiopathic migraine. Serotonergic mechanisms
may be implicated.
J. Neurol. Sci. 1998; 25: 151-153