الفهرس 
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Abstract
Background: Co-morbidity is defined as the co-occurrence of two medical conditions more frequently than would be expected by chance alone. Migraine and epilepsy are highly comorbid and share clinical features that suggest overlapping pathophysiological and etiological conditions of both as a neurological chronic disorders with episodic manifestations. Neurological chronic disorders with episodic manifestations (CDEM) are characterized by recurrent attacks of nervous system dysfunction with a return to baseline between attacks. Among the CDEM treated by neurologists, headaches (including migraine) and epilepsy are the most common, each comprising nearly 20% of outpatient neurological visits. Both migraine and epilepsy represent distinct families of neurological disorders with typical constellations of symptoms. Migraine is characterized by recurrent attacks of pain and associated symptoms. Epilepsy is characterized by recurrent attacks of positive neurological symptoms, often progressing to altered or lost consciousness, and, at times, convulsive features Patients and Methods: The study was conducted on 41 Egyptian patients at Mansoura University Hospital from April 2013 to September 2016 divided into 3 groups. The first (group 1) was fifteen (15) familial JME cases (JME patient with positive family history of JME or positive family history of another type of idiopathic generalized epilepsy IGE) with or without comorbid migraine. The second (group 2) was fourteen (14) sporadic cases (cases with negative family history of epilepsy) with or without comorbid migraine. And the third (group 3) was twelve (12) control cases (normal cases who are not epileptic or suffer from migraine with no family history of epilepsy with normal conventional MRI brain).in order to assess the comorbidity both clinical and functional between juvenile myoclonic epilepsy and migraine Results: the study showed about 50% association between juvenile myoclonic epilepsy and migraine without any difference in the clinical presentation of both of them either when occur alone or in association. And the MRS study although it is of importance in diagnosing JME it adds no value in explaining this clinical comorbidity. Conclusion: Juvenile myoclonic epilepsy and migraine are highly comorbid conditions; the co-existence of both diseases together is twice or triple the incidence of occurrence each one alone. Female gender, positive family history of migraine and frequent GTCs can be considered as risk factors for JME patients to develop migraine. Migraine criteria, when comorbid with JME did not differ from general criteria of migraine.Although MRS study is helpful in diagnosis of JME, it gives no added information about the functional comorbidity of JME and migraine in relation to the concentration of frontal lobe and thalamic metabolites (NAA, CHO and CR).