# Complex neurological interplay: adult-onset migraine-triggered seizures in schizencephaly—a case report

## TL;DR

A rare case of adult-onset seizures linked to schizencephaly highlights unusual neurological patterns and successful management with standard treatment.

## Contribution

This case report presents an atypical adult-onset seizure pattern in schizencephaly with migraine-like pre-seizure symptoms.

## Key findings

- The patient experienced adult-onset seizures despite having open lip schizencephaly, which is typically diagnosed in childhood.
- Migraine-like pain occurred seconds before each seizure, indicating a possible migrainous trigger for epilepsy.
- The patient maintained normal cognitive function and independence, managed symptoms with standard medication.

## Abstract

Schizencephaly is a rare congenital cerebral malformation typically diagnosed in early childhood due to serious neurological manifestations. Our case report described a patient with open lip schizencephaly, notable for three unique aspects. First, the patient experienced epileptic seizures in adulthood, which is atypical compared to the usual onset in childhood. Additionally, the patient reported migraine-like pain occurring seconds before each epileptic seizure, with a short interval and regular occurrence. Finally, contrary to the expected severity of symptoms in a patient with open lip schizencephaly, the patient was able to live independently in daily activities, maintained normal cognitive function, and effectively managed both seizures and headaches with standard medication. The purpose of this report is to highlight the significant role of schizencephaly as a causative factor in adult-onset epilepsy and to emphasize the need for a comprehensive therapeutic approach addressing both the structural and functional aspects of this complex neurodevelopmental condition (under the premise of schizencephaly, there were migraine-like attacks in the short term before epileptic seizures).