![]() ![]() The third edition of the International Classification of Headache Disorders (ICHD-III-beta version), 8 defines migraine with aura (MA) as ‘recurrent attacks, lasting minutes, of unilateral fully reversible visual, sensory or other central nervous system symptoms that usually develop gradually and are usually followed by headache and associated migraine symptoms.’ ICHD-III beta diagnostic criteria for ‘migraine with aura’ (code 1.2) are reported in Table 1.Ī typical migraine aura can be characterized by any combination of visual, somatosensory, or speech/language symptoms. ICHD-III Beta Definition and Diagnostic Criteria At present all the pathophysiologic mechanisms underlying migraine aura are not still understood but it seems clear that CSD, a primarily neuronal event, is an intrinsic property of the migrainous cerebral cortex and it is the responsible of the aura symptoms. 7 That data argued with the ischemic hypothesis and suggested that aura is primarily a neuronal event that is accompanied by vascular changes. Lauritzen and colleagues detected during a migraine aura a wave of oligemia starting from the occipital area, progressing onward at 2 to 3 mm per minute irrespective of arterial territories. ![]() In 1974 the advent of a technique of measurement of regional cerebral blood flow (rCBF) made it possible to detect spreading oligemia as a mild reduction of the rCBF above the ischemic threshold during migraine aura. 6 For some decades, the hypothesis that migraine aura was caused by a vasospasm and cortical ischemia was dominant. 5 In 1944 the Brazilian neurophysiologist Leão described first-in- rabbit brain a wave of excitation followed by a wave of inhibition of the electroencephalography spreading at a rate of 2 to 3 mm per minute and called it cortical spreading depression (CSD), commenting on its similarity with the migraine aura. 4 Lashley in 1941 chartered his own visual auras and concluded that the symptomatology reflected a cortical process progressing with a speed of 3 mm/minute across the primary visual cortex. This character, which seems important to understand the basis of migraine aura pathophysiology, suggested to Liveing in 1873 a ‘nerve storm’ was behind the symptoms. One of the main features of the aura, which differentiates it from a transient ischemic attack (TIA) or an epileptic seizure, is the slow progression of symptoms. Both the visual and sensory symptoms, which are the most common, may have a bimodal progression with positive features: shimmering lights, zig-zagging lines, prickling paresthesias, followed by negative ones, such as a blind spot or numbness. ![]() Sometimes a typical aura can be followed by a headache with a paucity of migrainous features or even not be followed by headache. 3 The aura consists of fully reversible visual, sensory, or language, more rarely motor or brainstem, symptoms, which usually last from 5 to 60 minutes and precede the appearance of a full migraine. 1,2 Migraine is essentially a disabling headache, characterized by moderate to severe head pain, usually accompanied by nausea, photophobia, and phonophobia that may be preceded by focal neurologic symptoms, which are called aura.Ībout 30 % of migraine patients experience aura in relation with their headaches. Migraine is a primary headache (HA) disorder affecting about 18 % of women and 6 % of men in the US and Western Europe. Migraine with aura, clinical characteristics, phenotype, phenomenology, length, duration Article: The susceptibility to generate a CSD seems to be an intrinsic property of the migrainous brain. Phenomenon that causes a progressive shutdown of the cerebral cortex, starting from the occipital area and spreading onward at a speed ofĢ to 3 mm per minute. The presumed substrate of migraine with aura is cortical spreading depression (CSD), a primarily neuronal The symptoms of the aura phase develop usually progressively over minutes and generally last for 5 to 60 minutes, although in a significant Neurologic symptoms, visual, sensory, or dysphasic, more rarely motor or brainstem, called ‘aura’ that are usually followed by a full migraine. Migraine with aura is characterized by transient focal About 30 % of patients with migraine suffer from episodes of migraine with aura.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |