Meta-analysis finds no clear link between migraine and epilepsy subtype

This systematic review and meta-analysis followed PRISMA 2020 guidance. The authors searched PubMed and Web of Science through April 1, 2026, for studies assessing migraine in people with epilepsy using formal diagnostic criteria or predefined ascertainment methods. Of 8,250 records identified, 15 studies were included in the qualitative review and six in the quantitative synthesis. Studies with a Newcastle–Ottawa Scale score of at least seven were included in the random-effects meta-analysis.

Migraine comorbidity was not significantly associated with epilepsy subtype (focal versus generalized; OR 1.10, 95% CI 0.84–1.43; I²=32.1%). The primary analysis also found no significant association with favorable seizure control (OR 0.70, 95% CI 0.45–1.11; I²=63.2%). An exploratory sensitivity analysis suggested an association between migraine and less favorable seizure control (OR 0.61, 95% CI 0.41–0.91; I²=47.6%).

The authors caution that the sensitivity finding is hypothesis-generating and requires confirmation in prospective, syndrome-specific studies using standardized outcomes. All pooled estimates were based on unadjusted data, limiting interpretation of the associations.