{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T14:35:03Z","timestamp":1762353303295,"version":"3.41.2"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Migraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic\/genetic epilepsy (I\/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I\/GEs with headaches who were diagnosed by an experienced headache expert.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this multicenter study including 809 consecutive patients with a diagnosis of I\/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I\/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Longer headache duration (&amp;lt;4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea\/vomiting, and photophobia and\/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I\/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo\/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (<jats:italic>n<\/jats:italic> = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Longer headache duration, throbbing pain, increase of pain by physical activity, photophobia and\/or phonophobia, presence of vertigo\/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I\/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I\/GEs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.1103541","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T21:47:37Z","timestamp":1673387257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnosis of comorbid migraine without aura in patients with idiopathic\/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria"],"prefix":"10.3389","volume":"13","author":[{"given":"Arife 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