Complicated migraines and migraine auras can cause positive
focal symptoms in all five senses and, as such, may mimic focal
(simple partial) seizures or epileptic auras. In addition, both migraine
and seizure focal symptoms ‘‘march.” The key differentiating
factor, as usual, is the time course: migraine symptoms tend
to evolve in minutes, whereas seizure symptoms evolve in seconds.
Usually, associated symptoms (migrainous headache or more obvious
seizure symptoms) make the diagnosis easy. Basilar migraine
can also cause LOC.