Migraine and epilepsy: genetically linked?
Most molecular genetic knowledge in migraine so far comes from the study of a rare subtype, familial hemiplegic migraine (FHM). The three known FHM genes (CACNA1A, ATP1A2 and SCN1A) are ion transporter genes. Mutations in all three FHM genes can also be associated with epilepsy. Of the many epilepsy genes that have been discovered, an association with migraine has been reported only for SCN1A. There is probably a lack of systematic studies of migraine in epilepsy families. A genetically determined dysfunction of ion transporters seems to point, at least to certain extent, at a common underlying mechanism for both paroxysmal disorders. The effect of ion channel mutations on neuronal neurotransmitter release is probably of major importance. In this article, we will discuss the arguments for a genetic relationship between migraine and epilepsy. A possible genetic link could give insight into the pathophysiology of both syndromes, and offer possibilities to develop specific preventive treatment aimed at the underlying ion transporter dysfunction and its consequences.
Haan
Joost
J
Department of Neurology K5Q, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. jhaan@rijnland.nl
van den Maagdenberg
Arn M J M
AM
Brouwer
Oebele F
OF
Ferrari
Michel D
MD