Prevalence of migraine in individuals with functional seizures: A systematic review and meta-analysis
Kyrgyzbay G. Kalinina D. Akhmedullin R. Utebekov Z. Kasenova A. Ornello R. Kimadiev D. Zhumabayeva G.
October 2025Elsevier B.V.
Epilepsy Research
2025#216
Background: This study aimed to understand the prevalence of migraine in patients with functional seizures in general, as well as compared to patients with epileptic seizures. Methods: We conducted a literature search of the PubMed, Scopus, and Web of Science databases from database inception until July, 2024. We identified studies using an observational design and performed a meta-analysis to evaluate the association between migraines and functional seizures. We assessed the quality of the studies with the Newcastle-Ottawa Scale, and identified the pooled odds ratios (OR) and mean differences. Heterogeneity was investigated using the I² statistic, significance was determined using Cochrans test, and a post-hoc Beggs test was performed. This study was registered with PROSPERO (CRD42024558536). Results: Of the 3248 studies identified, 13 studies (N = 2415) were eligible for inclusion. Out of 2415 patients with functional seizures, 763 (31.5 %) patients had comorbid migraine. The pooled OR for prevalence of migraine in individuals with functional seizures compared with those with epileptic seizures was 2.77 (95 % CI: 2.36–3.27), with a corresponding mean difference of 18 % ((95 % CI: 9 %-27 %). Quality assessment revealed moderate-to-high quality in all the included studies. Conclusion: This study revealed a high prevalence of migraine in patients with functional seizures. However, existing evidence is limited to a handful of observational studies. More studies are needed to evaluate the direction of the association and the clinical and therapeutic impact of migraine on functional seizures.
Comorbidity , Epilepsy , Functional seizures , Headache , Migraine , PNES
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Epileptology Centre, RSE Medical Centre Hospital of the Presidents Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
Department of Neurology, NpJSC “Astana Medical University”, Astana, Kazakhstan
Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
Institute of Continuing Professional Education, NpJSC “Astana Medical University”, Astana, Kazakhstan
Department of Biotechnological and Applied Clinical Sciences, University of L′Aquila, LAquila, Italy
Epileptology Centre
Department of Neurology
Department of Medicine
Institute of Continuing Professional Education
Department of Biotechnological and Applied Clinical Sciences
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