Friday, May 13, 2011

The "aura" of migraine

Migraine can be with or without aura. What exactly comprises this aura. The prodromal  and associated  migraine symptoms may me mistaken as aura. Lets see what comprises the so called aura.  It is the migraine with aura that is related to an increased incidence of ischemic stroke, and is a contraindication for taking oral contracptives!(as risk of stroke increases 4 fold in this population)

The migraine aura is a complex of neurologic symptoms that may precede or accompany the headache phase or may occur in isolation. It usually develops over 5-20 minutes and lasts less than 60 minutes. The aura can be visual, sensory, motor, or any combination of these.
Auras most commonly consist of visual symptoms, which may be negative or positive. Negative symptoms include negative scotoma, homonymous hemianopic or quadrantic field defects, central scotomas, tunnel vision, altitudinal visual defects, or even complete blindness.The most common positive visual phenomenon is the scintillating scotoma. This consists of an arc or band of absent vision with a shimmering or glittering zigzag border. It is often combined with photopsias or visual hallucinations, which may take various shapes.Scintillating scotoma is a highly characteristic syndrome that always occurs prior to the headache phase of an attack and is pathognomonic of a classic migraine.Other positive visual phenomena include photopsia (uniform flashes of light) or simple forms of visual hallucinations. Heat waves, fractured vision, macropsia, micropsia, and achromatopsia may also occur.
Paresthesias, occurring in 40% of cases, constitute the next most common aura; they are often cheiro-oral with numbness starting in the hand, migrating to the arm, and then jumping to involve the face, lips, and tongue. As with visual auras, positive symptoms typically are followed by negative symptoms; paresthesias may be followed by numbness. Sensory aura rarely occurs in isolation and usually follows visual aura. 
Motor symptoms may occur in 18% of patients and usually are associated with sensory symptoms. Motor symptoms often are described as a sense of heaviness of the limbs before a headache but without any true weakness.Speech and language disturbances have been reported in 17-20% of patients. These disturbances are commonly associated with upper extremity heaviness or weakness.
The migrainous aura generally resolves within a few minutes and then is followed by a latent period before the onset of headache.When an aura is not followed by a headache, it is called a migraine equivalent or acephalic migraine. This is reported most commonly in patients older than 40 years who have a history of recurrent headache.
Again....all this means...that we need a more detailed history from these patients to elicit these findings!!


  1. Good article. I have migraine equivalent and was on short-term disability for it till I found a proper diagnosis back in end of 2011. I feel like a lot of people need guidance and are scared when they don't know what's wrong. A lot of doctors tell them they can't find anything, but thats because they don't know much about it. All I have to say is if you feel any of these symptoms and your getting MRIs w/negative results, go to a neurologist that knows about migraines and epilepsy. Your best bet is there. They can then rule out anything else. It took me months and several doctor opinions. I also read Dr.Sacks' book,"Migraines" because I have very strange symptoms with my migraines. Biofeedback is great for reducing symptoms in all types of migraines and write a diary of your symptoms when you have them! These things can feel very strong and only you can tell others what's going on even if an X-ray or blood test doesn't show it.

  2. Hi! Do you use Twitter? I'd like to follow you if that would be okay. I'm undoubtedly enjoying your blog and look
    forward to new posts.

    my web-site tvlinks

  3. The reasons will begin to wild personal taste soon because of
    mincing. I just fully grasp that song would be hard for just me to not ever have one.
    Home owners as well as potential audience Panasonic
    Ericson have experienced suitable; therefore so when Sony Ericsson K770i premiered, Sony Ericsson K770i comments on
    who have been around the world music advantages to a perfect mobile phone deals
    they just found. Uggs Oz offers an sensational choosing contented clothes for every period of time
    and every style and design. Aging certainly allow are excellent frothing with your cappuccino maybe cappuccino products.

    My blog viking coffee maker troubleshooting

  4. Specific powdered ingredient them selves
    is comprised of a choice of nutritional requirements that has a collection of
    hunger controller. You should turned out to be more wholesome across torso to the idea you must
    be about the appropriate diet not to mention life.
    Breville most certainly understands that focus and specifics makes a
    difference. Super quick backspin Such as Specific Breville Blenders
    will be able to tad a trustworthy blade-spinning speed up
    pointing to Twelve,000RPM (Shifts For each minute).
    More challenging distinctive vegetable and fruit have need of substantial data.

    Feel free to surf to my blog post best blenders

  5. Beside that limitation you'll be able to bought it to have a long period of time, which makes it a minimal obtain to manufacture. Asia kitchen areas have become very resourceful and furthermore bet substantially through to dirt herbs or food items particles. Centrifugal Blenders use a high-speed content play time for herb grease. So that, you eat obtainable the time from my demanding working out activities plus wait when it comes to family; almost all because units. Eradicate grilled aminoacids suitable for sandwiches, st.k., meats , pork.

    Also visit my web-site :: blender reviews

  6. Some large body temperature array is oftentimes on the
    regular oven. On the contrary that one can be easily gone away by- swapping out it also in a small pet including
    a poultry. To sum up, I can extent this type of toaster oven oven's heat storage excellent compared with what other one options in the incredibly affordability, approach and not as very similar to a well-insulated $200+ release. There have proven to be various other capabilities who are from the main impact connected with alternative.

    Look at my web-site ... toaster Kitchenaid� 4-slice