IHS	Diagnosis	ICD-10
7.6	Headache attributed to epileptic seizure [G40.x or G41.x to specify seizure type]	G44.82

Comment:

The association between migraine and epilepsy is complex and bi-directional. It may be related to genetic and/or environmental risk factors that increase neuronal excitability or decrease the threshold to both types of attacks. Migraine and epilepsy may coexist without either being a contributing risk factor for the other. Migraine and epilepsy may be co-morbid as certain brain disorders (eg, MELAS) predispose patients to both epilepsy and migraine occurring remotely from each other. There appears also to be a high incidence of migraine in certain forms of epilepsy such as benign occipital epilepsy, benign rolandic epilepsy and corticoreticular epilepsy with absence seizures. Furthermore, structural lesions such as arteriovenous malformations may present with clinical features of migraine with aura along with seizures, usually accompanied by headache. Finally, seizures have been reported to occur during or immediately following a migraine aura. The term migralepsy has been used to denote epileptic seizures occurring between the migrainous aura and the headache phase of migraine. There should be no reason why epileptic seizures, so vulnerable to extrinsic and intrinsic precipitating factors, could not be susceptible to cortical changes induced by migraine. However, this is so extremely rare that only a few case reports have been published despite that migraine and epilepsy are among the commonest brain diseases. According to a recent review, most of these are genuine occipital seizures imitating migraine aura. For example, two of the three "migralepsy" patients of Lennox and Lennox (1960) seemed to have symptomatic and idiopathic occipital epilepsy with visual hallucinations.