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Erhöhte zerebrale Erregbarkeit und "spreading depression"

Ursachen für eine Komorbidität von Epilepsie und Migräne?

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Zusammenfassung

Das gehäufte gemeinsame Auftreten und der Nachweis klinischer Gemeinsamkeiten von Epilepsie und Migräne werfen die Fragen nach einem gemeinsamen pathophysiologischen Modell der Erkrankungen auf. Jedoch fehlen bisher Hinweise für eine genetische Disposition der Komorbidität. Neuere klinische Studien bestätigen eine unspezifische Assoziation von Epilepsien und Migräne. Sie beruht am ehesten auf dem pathophysiologischen Mechanismus der "spreading depression" als ein Ausdruck für eine erhöhte zerebrale Erregbarkeit, die bei beiden Erkrankungen zu finden ist. Liegen beide Erkrankungen vor, bietet sich eine Migräneprophylaxe mit den Antikonvulsiva Valproinsäure, Gabapentin oder Topiramat an.

Summary

Increased co-occurrence and common clinical aspects of epilepsy and migraine lead to the question of a common pathophysiological model of the diseases. Shared genetic risk factors as an explanation for comorbidity could not be proven. Clinical studies underline the unspecific association of migraine and epilepsy. Comorbidity is based on spreading depression as an expression of altered brain state with neuronal hyperexcitability. In comorbid conditions, therapy with valproate, gabapentin, or topiramate may be effective.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurologie, Universitätsklinik Essen

    T. Leniger, H. C. Diener & A. Hufnagel

  2. Klinik und Poliklinik für Neurologie, Universitätsklinik Essen, Hufelandstraße 55, 45122 , Essen

    T. Leniger

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  1. T. Leniger
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  2. H. C. Diener
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  3. A. Hufnagel
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Correspondence to T. Leniger.

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Leniger, T., Diener, H.C. & Hufnagel, A. Erhöhte zerebrale Erregbarkeit und "spreading depression". Nervenarzt 74, 869–874 (2003). https://doi.org/10.1007/s00115-003-1538-x

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