Medical Hypotheses Essay

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Medical Hypotheses (2006) 66, 466–472 http://intl.elsevierhealth.com/journals/mehy Epilepsy and migraine: The dopamine hypotheses Shih-Cheng Chen * Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, ROC Received 22 September 2005; accepted 27 September 2005 Summary Migraine and epilepsy are both chronic recurrent disorders with paroxysmal attacks. They also share some similar risk factors, symptoms, and preventive medications. Dopamine has long been postulated to be involved in the pathophysiology of migraine and epileptogenesis, by many supporting evidences. However, the role of dopamine is still controversial till now. A lack of a comprehensive hypothetical model may be one of the reasons. ‘‘Dopamine hypothesis’’ is not a new term, but it is proposed to explain the pathophysiology and the associated phenomena of these disorders. The hypotheses suggest that, in migraine, there is a low dopamine tone, while there is a high state of dopamine in generalized epilepsy. But the periodic attacks of headaches and seizures maybe both due to a fall in dopamine activity. Dopamine therefore plays a key role in the linkage of neuroendocrine, autonomic system and neuronal activity. Dopamine agonist is also implied in prophylaxis and neuroprotection in both disorders. c 2005 Elsevier Ltd. All rights reserved.  Introduction Migraine and epilepsy are categorized as paroxysmal disorders. They are both chronic recurrent disorders with episodic attacks. Besides the two disorders have several similarities and associations, which are listed as follows [1]: 1. They are both heterogeneous disorders with periodic nature in common. 2. The attacks of headaches and seizures tend to go through typical courses, which may include prodromal phase, aura, and postdrome. 3.

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