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Peter J. Goadsby - One of the best experts on this subject based on the ideXlab platform.
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Proposal for a Migraine Aura Complexity Score.
Cephalalgia : an international journal of headache, 2018Co-Authors: Igor Petrusic, Michele Viana, Marko Dakovic, Peter J. Goadsby, Jasna Zidverc-trajkovicAbstract:Currently, there is no scoring system for assessing the complexity of Migraine Aura. Our goal was to develop a Migraine Aura Complexity Score that synthesizes the quantity and quality of Aura symptoms and to test its applicability in neuroimaging studies. Patients with Migraine Aura were interviewed in order to obtain characteristics of Migraine Aura. Explorative and confirmatory analyses were used to develop the Migraine Aura Complexity Score. Median values were derived from 10 consecutive Migraine Auras in each patient. The Migraine Aura Complexity Score was correlated with an average cortical thickness of different brain areas in studied patients. The Surface-based Morphometric Analysis approach was used to estimate cortical thickness. This study included 23 (16 females and seven males) Migraineurs with Aura. Confirmatory factor analysis suggested the second-order model with three-factor measurement for grading Migraine Aura. The first factor is linked to higher cortical dysfunction during Migraine Aura, while the second is associated with the degree of involvement of primary visual and somatosensory cortices; the third linked symptoms of somatosensory Aura and hand and head involvement. Positive correlation of Migraine Aura Complexity Score and averaged cortical thickness were found in the left and right hemispheres overall (r = 0.568, p = 0.007; r = 0.617, p = 0.003) and in some of their regions. This study demonstrates that the Migraine Aura Complexity Score could be a valuable tool for assessing Migraine Aura. The score could be used in neuroradiological studies in order to achieve a stratification of patients with Migraine Aura.
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Clinical features of Migraine Aura: Results from a prospective diary-aided study:
Cephalalgia : an international journal of headache, 2016Co-Authors: Michele Viana, Peter J. Goadsby, Grazia Sances, Mattias Linde, Natascia Ghiotto, Elena Guaschino, Marta Allena, Salvatore Terrazzino, Giuseppe Nappi, Cristina TassorelliAbstract:Background A detailed evaluation of Migraine Aura symptoms is crucial for classification issues and pathophysiological discussion. Few studies have focused on the detailed clinical aspects of Migraine Aura. Methods We conducted a prospective diary-based study of Migraine Aura features including presence, quality, laterality, duration of each Aura symptom, their temporal succession; presence of headache and its temporal succession with Aura. Results Seventy-two patients completed the study recording the characteristics of three consecutive Auras ( n = 216 Auras). Visual symptoms occurred in 212 (98%), sensory symptoms in 77 (36%) and dysphasic symptoms in 22 (10%). Most Auras had more than one visual symptom (median 2, IQR 1-3, range 1-4). The majority of patients (56%) did not report a stereotyped Aura on the three attacks with respect to visual features, the combination and/or temporal succession of the three Aura symptoms. Fifty-seven percent of patients also reported a different scenario of temporal succession between Aura and headache in the three attacks. Five per cent of Aura symptoms were longer than four hours. Conclusion These findings show a high inter- and intravariability of Migraine with Aura attacks. Furthermore, they provide reliable data to enrich and clarify the spectrum of the Aura phenotype.
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Migraine Aura symptoms: Duration, succession and temporal relationship to headache.
Cephalalgia : an international journal of headache, 2015Co-Authors: Michele Viana, Peter J. Goadsby, Grazia Sances, Mattias Linde, Natascia Ghiotto, Elena Guaschino, Marta Allena, Salvatore Terrazzino, Giuseppe Nappi, Cristina TassorelliAbstract:BackgroundAs there are no biological markers, a detailed description of symptoms, particularly temporal characteristics, is crucial when diagnosing Migraine Aura. Hitherto these temporal aspects have not been studied in detail.MethodsWe conducted a prospective diary-aided study of the duration and the succession of Aura symptoms and their temporal relationship with headache.ResultsFifty-four patients completed the study recording in a diary the characteristics of three consecutive Auras (n = 162 Auras). The median duration of visual, sensory and dysphasic symptoms were 30, 20 and 20 minutes, respectively. Visual symptoms lasted for more than one hour in 14% of Auras (n = 158), sensory symptoms in 21% of Auras (n = 52), and dysphasic symptoms in 17% of Auras (n = 18). Twenty-six percent of patients had at least one Aura out of three with one symptom lasting for more than one hour. In Aura with multiple symptoms the subsequent symptom, second versus first one or third versus second, might either start simul...
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Visual Snow—Persistent Positive Visual Phenomenon Distinct from Migraine Aura
Current pain and headache reports, 2015Co-Authors: Christoph J. Schankin, Peter J. GoadsbyAbstract:Patients with visual snow complain of uncountable flickering tiny dots in the entire visual field similar to the view of a badly tuned analogue TV channel (TV snow). The symptoms are often continuous and can persist over years. This condition is grouped among the persistent visual phenomena in Migraine, although it clinically presents a unique entity distinct from persistent Migraine Aura or Migraine Aura status. Here, we review the recent literature leading to the identification of the visual snow syndrome. The additional visual and non-visual symptoms are described in detail, and criteria are presented for future studies. Using these criteria, the relationship to Migraine and typical Migraine Aura was recently evaluated. Further, patients with visual snow differ from controls in respect of hypermetabolism in the supplementary visual cortex (lingual gyrus). This provides evidence that visual snow, despite being purely subjective in the individual patient, has a clear biological basis. The area of hypermetabolism overlaps with the functional correlates of photophobia in Migraine supporting the close relationship of Migraine and visual snow.
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visual snow persistent positive visual phenomenon distinct from Migraine Aura
Current Pain and Headache Reports, 2015Co-Authors: Christoph J. Schankin, Peter J. GoadsbyAbstract:Patients with visual snow complain of uncountable flickering tiny dots in the entire visual field similar to the view of a badly tuned analogue TV channel (TV snow). The symptoms are often continuous and can persist over years. This condition is grouped among the persistent visual phenomena in Migraine, although it clinically presents a unique entity distinct from persistent Migraine Aura or Migraine Aura status. Here, we review the recent literature leading to the identification of the visual snow syndrome. The additional visual and non-visual symptoms are described in detail, and criteria are presented for future studies. Using these criteria, the relationship to Migraine and typical Migraine Aura was recently evaluated. Further, patients with visual snow differ from controls in respect of hypermetabolism in the supplementary visual cortex (lingual gyrus). This provides evidence that visual snow, despite being purely subjective in the individual patient, has a clear biological basis. The area of hypermetabolism overlaps with the functional correlates of photophobia in Migraine supporting the close relationship of Migraine and visual snow.
Christoph J. Schankin - One of the best experts on this subject based on the ideXlab platform.
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The Index Vein Pointing to the Origin of the Migraine Aura Symptom: A Case Series
Neurology, 2020Co-Authors: Nedelina Slavova, Niklaus Denier, Marwan El-koussy, Roland Wiest, Frauke Kellner-weldon, Urs Fischer, Christoph J. SchankinAbstract:This case series describes and discusses the potential clinical utility of a prominent vein (index vein) found on susceptibility-weighted MRI during Migraine Aura that drains the cortical area responsible for patients' symptoms. Six patients with acute Migraine Aura had a prominent draining sulcal vein on emergency MRI done initially for suspected stroke. The location of the prominent vein was correlated to patients' symptoms, and the diameter was compared to the corresponding contralateral vein. In our patients with typical Migraine Aura, an accentuated sulcal vein pointed towards the cortical area correlating with the clinical presentation. Such an index vein outstands the ipsilateral area of hypoperfusion and exceeds the corresponding contralateral vessel in diameter by a factor 2.0 ± 1.6 (mean ± SD). This case series provides a definition of an index vein in MRI pointing to the area where the patients' symptoms originate. Although confirmation in a larger systematic study is necessary, the presence of such an index vein might support that, in patients with an acute neurologic deficit, Migraine Aura is the underlying etiology. © 2020 American Academy of Neurology.
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Visual Snow—Persistent Positive Visual Phenomenon Distinct from Migraine Aura
Current pain and headache reports, 2015Co-Authors: Christoph J. Schankin, Peter J. GoadsbyAbstract:Patients with visual snow complain of uncountable flickering tiny dots in the entire visual field similar to the view of a badly tuned analogue TV channel (TV snow). The symptoms are often continuous and can persist over years. This condition is grouped among the persistent visual phenomena in Migraine, although it clinically presents a unique entity distinct from persistent Migraine Aura or Migraine Aura status. Here, we review the recent literature leading to the identification of the visual snow syndrome. The additional visual and non-visual symptoms are described in detail, and criteria are presented for future studies. Using these criteria, the relationship to Migraine and typical Migraine Aura was recently evaluated. Further, patients with visual snow differ from controls in respect of hypermetabolism in the supplementary visual cortex (lingual gyrus). This provides evidence that visual snow, despite being purely subjective in the individual patient, has a clear biological basis. The area of hypermetabolism overlaps with the functional correlates of photophobia in Migraine supporting the close relationship of Migraine and visual snow.
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visual snow persistent positive visual phenomenon distinct from Migraine Aura
Current Pain and Headache Reports, 2015Co-Authors: Christoph J. Schankin, Peter J. GoadsbyAbstract:Patients with visual snow complain of uncountable flickering tiny dots in the entire visual field similar to the view of a badly tuned analogue TV channel (TV snow). The symptoms are often continuous and can persist over years. This condition is grouped among the persistent visual phenomena in Migraine, although it clinically presents a unique entity distinct from persistent Migraine Aura or Migraine Aura status. Here, we review the recent literature leading to the identification of the visual snow syndrome. The additional visual and non-visual symptoms are described in detail, and criteria are presented for future studies. Using these criteria, the relationship to Migraine and typical Migraine Aura was recently evaluated. Further, patients with visual snow differ from controls in respect of hypermetabolism in the supplementary visual cortex (lingual gyrus). This provides evidence that visual snow, despite being purely subjective in the individual patient, has a clear biological basis. The area of hypermetabolism overlaps with the functional correlates of photophobia in Migraine supporting the close relationship of Migraine and visual snow.
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the relation between Migraine typical Migraine Aura and visual snow
Headache, 2014Co-Authors: Peter J. Goadsby, Christoph J. Schankin, Farooq H. Maniyar, Till Sprenger, Denise E. Chou, Michael A. EllerAbstract:Objective To assess the relationship between the phenotype of the “visual snow” syndrome, comorbid Migraine, and typical Migraine Aura on a clinical basis and using functional brain imaging. Background Patients with “visual snow” suffer from continuous TV-static-like tiny flickering dots in the entire visual field. Most patients describe a syndrome with additional visual symptoms of the following categories: palinopsia (“afterimages” and “trailing”), entopic phenomena arising from the optic apparatus itself (floaters, blue field entoptic phenomenon, photopsia, self-light of the eye), photophobia, nyctalopia (impaired night vision), as well as the non-visual symptom tinnitus. The high prevalence of Migraine and typical Migraine Aura in this population has led to the assumption that “visual snow” is caused by persistent Migraine Aura. Due to the lack of objective measures, alternative diagnoses are malingering or a psychogenic disorder. Methods (1) The prevalence of additional visual symptoms, tinnitus, and comorbid Migraine as well as typical Migraine Aura was assessed in a prospective semi-structured telephone interview of patients with “visual snow.” Correlations were calculated using standard statistics with P < .05 being considered statistically significant. (2) Areas with increased brain metabolism in a group of “visual snow” patients in comparison to healthy controls were identified using [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography and statistical parametric mapping (SPM8 with whole brain analysis; statistical significance was defined by P < .001 uncorrected for multiple comparisons). Results (1) Of 120 patients with “visual snow,” 70 patients also had Migraine and 37 had typical Migraine Aura. Having comorbid Migraine was associated with an increased likelihood of having palinopsia (odds ratio [OR] 2.8; P = .04 for “afterimages” and OR 2.6; P = .01 for “trailing”), spontaneous photopsia (OR 2.9; P = .004), photophobia (OR 3.2; P = .005), nyctalopia (OR 2.7; P = .01), and tinnitus (OR 2.9; P = .006). Typical Migraine Aura was associated with an increased likelihood of spontaneous photopsia (OR 2.4; P = .04). (2) After adjusting for typical Migraine Aura, comparison of 17 “visual snow” patients with 17 age and gender matched controls showed brain hypermetabolism in the right lingual gyrus (Montreal Neurological Institute coordinates 16-78-5; kE = 101; ZE = 3.41; P < .001) and the left cerebellar anterior lobe adjacent to the left lingual gyrus (Montreal Neurological Institute coordinates -12-62-9; kE = 152; ZE = 3.28; P = .001). Conclusions —Comorbid Migraine aggravates the clinical phenotype of the “visual snow” syndrome by worsening some of the additional visual symptoms and tinnitus. This might bias studies on “visual snow” by Migraineurs offering study participation more likely than non-Migraineurs due to a more severe clinical presentation. The independence of entoptic phenomena from comorbid Migraine indicates “visual snow” is the main determinant. The hypermetabolic lingual gyrus confirms a brain dysfunction in patients with “visual snow.” The metabolic pattern differs from interictal Migraine with some similarities to migrainous photophobia. The findings support the view that “visual snow,” Migraine, and typical Migraine Aura are distinct syndromes with shared pathophysiological mechanisms that need to be addressed in order to develop rational treatment strategies for this disabling condition.
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The Relation Between Migraine, Typical Migraine Aura and “Visual Snow”
Headache, 2014Co-Authors: Christoph J. Schankin, Farooq H. Maniyar, Till Sprenger, Denise E. Chou, Michael A. Eller, Peter J. GoadsbyAbstract:Objective To assess the relationship between the phenotype of the “visual snow” syndrome, comorbid Migraine, and typical Migraine Aura on a clinical basis and using functional brain imaging. Background Patients with “visual snow” suffer from continuous TV-static-like tiny flickering dots in the entire visual field. Most patients describe a syndrome with additional visual symptoms of the following categories: palinopsia (“afterimages” and “trailing”), entopic phenomena arising from the optic apparatus itself (floaters, blue field entoptic phenomenon, photopsia, self-light of the eye), photophobia, nyctalopia (impaired night vision), as well as the non-visual symptom tinnitus. The high prevalence of Migraine and typical Migraine Aura in this population has led to the assumption that “visual snow” is caused by persistent Migraine Aura. Due to the lack of objective measures, alternative diagnoses are malingering or a psychogenic disorder. Methods (1) The prevalence of additional visual symptoms, tinnitus, and comorbid Migraine as well as typical Migraine Aura was assessed in a prospective semi-structured telephone interview of patients with “visual snow.” Correlations were calculated using standard statistics with P
Gunnar Bovim - One of the best experts on this subject based on the ideXlab platform.
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Migraine Aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy
BMC Medicine, 2007Co-Authors: Janne Marit Ertresvg, Lars Jacob Stovner, Lene Ekern Kvavik, Hans-jorgen Johnsen, John-anker Zwart, Grethe Helde, Gunnar BovimAbstract:Background Migraine Aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis. Methods During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years. Results Migraine with Aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up. Conclusion The diagnosis of Migraine Aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-Migraineous type. The Aura features were more complex, with several Aura symptoms and a higher prevalence of sensory and dysphasic Aura than usual. Gradually developing Aura symptoms, or different Aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating Aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that Migraine with Aura in pregnancy usually has a good prognosis with regard to cerebrovascular events.
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Migraine Aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy
BMC medicine, 2007Co-Authors: Janne Marit Ertresvg, Lars Jacob Stovner, Lene Ekern Kvavik, Hans-jorgen Johnsen, John-anker Zwart, Grethe Helde, Gunnar BovimAbstract:Migraine Aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis. During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years. Migraine with Aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up. The diagnosis of Migraine Aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-Migraineous type. The Aura features were more complex, with several Aura symptoms and a higher prevalence of sensory and dysphasic Aura than usual. Gradually developing Aura symptoms, or different Aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating Aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that Migraine with Aura in pregnancy usually has a good prognosis with regard to cerebrovascular events.
Michele Viana - One of the best experts on this subject based on the ideXlab platform.
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The depiction of Migraine visual Aura on the internet
Cephalalgia : an international journal of headache, 2020Co-Authors: Michele Viana, Anders Hougaard, Thien PhuAbstract:The most common and multifaceted Migraine Aura symptoms are visual disturbances. Health information is one of the most popular topics on the internet but the quality and reliability of publicized information is unknown. The aim of this study was to analyze images of Migraine Aura on Google to determine the frequency of correct presentations of visual Aura and distribution of visual Aura phenotypes. Two authors screened the 100 highest indexed Migraine Aura related images on Google. The content of the images was categorized into elementary visual symptoms. Forty out of 100 images were accurate representations of visual Migraine Aura. Such images included 31 different visual Aura phenotypes. The majority had more than one elementary visual symptom (median 2, IQR 1-3), most commonly "bean-like" forms (45%), zigzag lines (40%), and foggy/blurred vision (33%). Forty percent of images were accurate portrayals of visual Migraine Aura symptoms, but these presented limited phenotypes. The information derived from the internet photos may hinder the effective recognition of Aura symptoms. Thus, there is a need to provide a more comprehensive representation of visual Migraine Aura symptoms on the internet.
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Dysphasia and Other Higher Cortical Dysfunctions During the Migraine Aura-a Systematic Review of Literature.
Current pain and headache reports, 2020Co-Authors: Igor Petrusic, Michele Viana, Chiara Zecca, Jasna Zidverc-trajkovicAbstract:Although visual and somatosensory disturbances are the most common Migraine Aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of this review is to provide an overview of studies that report symptoms of dysphasia and other higher cortical dysfunctions (HCDs) during MA, as well as to determine the frequency of HCDs. Five studies met the inclusion criteria, corresponding to 697 patients overall. The most frequently reported HCDs were those of the language group (range 10-53%). The occurrence of visual HCDs was noted in 12-40 patients, somatosensory HCDs in 12-20%, and memory disturbances in 10-22% of the patients during MAs. MA is associated with a wide range of neurological symptoms, including symptoms of HCD. A better strategy for investigation of the HCD symptoms is needed to correctly stratify patients thus allowing meaningful studies of Aura pathophysiology.
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Dysphasia and Other Higher Cortical Dysfunctions During the Migraine Aura—a Systematic Review of Literature
Current Pain and Headache Reports, 2020Co-Authors: Igor Petrusic, Michele Viana, Chiara Zecca, Jasna Zidverc-trajkovicAbstract:Purpose of the Review Although visual and somatosensory disturbances are the most common Migraine Aura (MA) symptoms, patients can also experience other symptoms during their MA. The aim of this review is to provide an overview of studies that report symptoms of dysphasia and other higher cortical dysfunctions (HCDs) during MA, as well as to determine the frequency of HCDs. Recent Findings Five studies met the inclusion criteria, corresponding to 697 patients overall. The most frequently reported HCDs were those of the language group (range 10–53%). The occurrence of visual HCDs was noted in 12–40 patients, somatosensory HCDs in 12–20%, and memory disturbances in 10–22% of the patients during MAs. Summary MA is associated with a wide range of neurological symptoms, including symptoms of HCD. A better strategy for investigation of the HCD symptoms is needed to correctly stratify patients thus allowing meaningful studies of Aura pathophysiology.
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Application of the Migraine Aura Complexity Score (MACS): Clinical and Neuroimaging Study.
Frontiers in neurology, 2019Co-Authors: Igor Petrusic, Michele Viana, Marko Dakovic, Jasna Zidverc-trajkovicAbstract:Background: Manifestations of typical Migraine Aura can be numerous. Investigation of its pathophysiological mechanisms can be challenging if a stratification of phenotypes is not performed. In this context, the Migraine Aura Complexity Score (MACS), recently developed, may help. Here we aimed to categorize Migraine patients into homogenous groups using MACS and to compare those groups with respect to patients' characteristics and neuroimaging findings. Methods: Participants who have a Migraine with Aura (MwA) were interviewed after each attack in order to obtain the characteristics of Migraine Aura. Thereafter, we scored the complexity of their Auras by MACS. The MACS was used to categorize patients into three groups: MwA-S (with simple Aura), MwA-MC (with moderately complex Aura), and MwA-C (with complex Aura). The patient characteristics and estimated cortical thickness of regions of interest, which are potentially linked to the symptoms that develop during the Aura, were used to compare these groups. Results: In total, 338 MwA attacks were recorded in analyzed groups. Scotoma was the most frequently reported symptom in the groups, followed by somatosensory Aura in the MwA-C group and zig-zag lines in the MwA-MC and MwA-S groups. Patients in the MwA-C and MwA-MC groups had a thicker cortex in the left primary visual cortex with respect to MwA-S group. In addition, patients in the MwA-C group had a thicker cortex in several visual and somatosensory cortical regions relative to the MwA-S group. Conclusions: Our results show that the newly developed MACS can be used for the stratification of MwA patients, herewith allowing the better investigation of changes in Migraineurs' brains.
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Clinical features of visual Migraine Aura: a systematic review.
The journal of headache and pain, 2019Co-Authors: Michele Viana, Erling Tronvik, Thien Phu, Chiara Zecca, Anders HougaardAbstract:Migraine Aura (MA) is a common and disabling neurological condition, characterized by transient visual, and less frequently sensory and dysphasic Aura disturbances. MA is associated with an increased risk of cardiovascular disorders and is often clinically difficult to distinguish from other serious neurological disorders such as transient ischemic attacks and epilepsy. Optimal clinical classification of MA symptoms is important for more accurate diagnosis and improved understanding of the pathophysiology of MA through clinical studies. A systematic review of previous prospective and retrospective systematic recordings of visual Aura symptoms (VASs) was performed to provide an overview of the different types of visual phenomena occurring during MA and their respective frequencies in patients. We found 11 retrospective studies and three prospective studies systematically describing VASs. The number of different types of VASs reported by patients in the studies ranged from two to 23. The most common were flashes of bright light, “foggy” vision, zigzag lines, scotoma, small bright dots and ‘like looking through heat waves or water’. We created a comprehensive list of VAS types reported by Migraine patients based on all currently available data from clinical studies, which can be used for testing and validation in future studies. We propose that, based on this work, an official list of VAS types should be developed, preferably within the context of the International Classification of Headache Disorders of the International Headache Society.
Janne Marit Ertresvg - One of the best experts on this subject based on the ideXlab platform.
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Migraine Aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy
BMC Medicine, 2007Co-Authors: Janne Marit Ertresvg, Lars Jacob Stovner, Lene Ekern Kvavik, Hans-jorgen Johnsen, John-anker Zwart, Grethe Helde, Gunnar BovimAbstract:Background Migraine Aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis. Methods During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years. Results Migraine with Aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up. Conclusion The diagnosis of Migraine Aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-Migraineous type. The Aura features were more complex, with several Aura symptoms and a higher prevalence of sensory and dysphasic Aura than usual. Gradually developing Aura symptoms, or different Aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating Aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that Migraine with Aura in pregnancy usually has a good prognosis with regard to cerebrovascular events.
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Migraine Aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy
BMC medicine, 2007Co-Authors: Janne Marit Ertresvg, Lars Jacob Stovner, Lene Ekern Kvavik, Hans-jorgen Johnsen, John-anker Zwart, Grethe Helde, Gunnar BovimAbstract:Migraine Aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis. During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years. Migraine with Aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up. The diagnosis of Migraine Aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-Migraineous type. The Aura features were more complex, with several Aura symptoms and a higher prevalence of sensory and dysphasic Aura than usual. Gradually developing Aura symptoms, or different Aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating Aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that Migraine with Aura in pregnancy usually has a good prognosis with regard to cerebrovascular events.