Perceptions of Modulatory Factors in Migraine and Epilepsy: A Multicenter Study

Emel Ur Özçelik; Katia Lin; Ruta Mameniškienè; Juiane Sauter Dalbem; Heloise Helena Siqueira; Rūta Samaitienė; Luz Eleonora Vega Zeissig; Armando Ferreira Fonseca Jr; Juliana Mazini Alves; Mariana Dos Santos Lunardi; Luiz Paulo de Queiroz; Erika Zubavičiūtė; Peter Wolf; Betül Baykan

doi:10.3389/fneur.2021.672860

Perceptions of Modulatory Factors in Migraine and Epilepsy: A Multicenter Study

Front Neurol. 2021 Jun 3:12:672860. doi: 10.3389/fneur.2021.672860. eCollection 2021.

Authors

Emel Ur Özçelik¹, Katia Lin², Ruta Mameniškienè³, Juiane Sauter Dalbem^{2

4}, Heloise Helena Siqueira^{2

4}, Rūta Samaitienė⁵, Luz Eleonora Vega Zeissig⁶, Armando Ferreira Fonseca Jr², Juliana Mazini Alves², Mariana Dos Santos Lunardi², Luiz Paulo de Queiroz², Erika Zubavičiūtė⁷, Peter Wolf^{2

8}, Betül Baykan¹

Affiliations

¹ Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
² Department of Neurology, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
³ Centre for Neurology, Vilnius University, Vilnius, Lithuania.
⁴ Department of Neurology, Universidade Federal de Mato Grosso, Cuiabá, Brazil.
⁵ Faculty of Medicine, Clinic of Children's Diseases, Vilnius University, Vilnius, Lithuania.
⁶ Centro de Epilepsia Humana y Neurocirurgia Funcional, Guatemala City, Guatemala.
⁷ Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
⁸ Danish Epilepsy Center, Dianalund, Denmark.

Abstract

Background: Migraine and epilepsy are both common episodic disorders, typically precipitated or inhibited by some modulatory factors (MFs). Objective: To assess the self-perception of MFs in patients with migraine (PWM) compared to patients with epilepsy (PWE) with a standardized protocol in different countries. Methods: Transcultural multicenter comparative cross-sectional study. All consecutive patients who fulfilled the ICHD-3 criteria for migraine and ILAE's criteria for epilepsy, with at least 1 year of follow-up were interviewed with a semi-structured questionnaire on clinical and epidemiological data and were asked to identify all experienced MFs from a provided list. Results: A total of 608 individuals were surveyed at five university referral centers in Brazil, Guatemala, Lithuania and Turkey. Two hundred and nineteen (91.6%) PWM and 305 (82.7%) PWE identified attack precipitating factors (PFs; p < 0.001). The most frequent three PFs reported by epilepsy patients were: "lack of sleep" (56.6%), "emotional stress" (55.3%), "negative feelings" (53.9%), while among migraine patients "emotional stress" (81.6%), "lack of sleep" (77.8%), "negative feelings" (75.7%) were cited. Inhibitory factors (IFs) for the episodes were reported by 68 (28.5%) PWM and 116 (31.4%) PWE. "Darkness" was the most common one, described by 35.6% of PWM whereas "positive feelings" reported by 10.6% of PWE. Most MFs are concordant across the countries but some transcultural differences were noted. Conclusion: The MFs of migraine and epilepsy attacks and their varying frequencies according to different countries were investigated with the same standardized questionnaire, for the first time. MFs were recognized very often in both migraine and epilepsy cohorts, but in distinct disease-specific prevalence, being more frequent in migraine. Recognition of self-perceived MFs may be helpful for the management of both illnesses.

Keywords: epilepsy; exogenous modulators; inhibitory factors; migraine; precipitant factors; self-awareness.