1.4.4 Migraine aura-triggered seizure

Clinical History: The patient reports a history of migraine with aura since adolescence, characterized by visual symptoms (scintillating scotomas) followed by unilateral pulsatile headache, nausea, and photophobia. In the past 6 months, she has experienced episodes of migraine aura without headache, lasting 20 to 30 minutes. On two occasions, immediately following the aura, she developed a generalized tonic-clonic seizure lasting approximately 1 minute, followed by postictal confusion and drowsiness. There is no history of fever, head trauma, or illicit substance use. Physical and Neurological Examination: General physical examination: unremarkable. Neurological examination: normal in the interictal period. Additional Investigation: Cranial magnetic resonance imaging: normal. Electroencephalogram (EEG): epileptiform discharges in the left occipital region, consistent with epileptogenic activity.