Symptom Migraine Epilepsy
Premonitory Common Often
Duration of aura 15-60 mins Brief, often less than 1 min
Automatisms Unusual Frequent for complex partial seizures
Gastrointestinal aura Abdominal pain rare; nausea common "Butterflies" (rising epigastric sensation)
Visual disturbances See text of Phases and Differential diagnosis: clinical features
Paresthesias Common (5-60 mins) Common (seconds to minutes)
Altered consciousness Usually responsive Often unresponsive
Olfactory aura Very uncommon More common
Aphasia Common Common
Déjà vu Rare Common

Adapted from: Silberstein, SD, and Lipton RB. Headache and epilepsy. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;239-254. With permission from Elsevier (

Authored By: 
SD Silberstein
RB Lipton
Reviewed By: 
Steven C. Schachter MD
Wednesday, March 31, 2004