Spotlight on Migraine aura without headache

Migraine is a common neurologic disorder that is prevalent in the younger population. With age, migraine prevalence decreases, but some people continue to experience migraine auras without the subsequent or associated headache pain. In this article, Dr. Shih-Pin Chen of the National Yang-Ming University School of Medicine reviews the clinical manifestations, prevalence, pathophysiology, therapeutic options, and prognosis for this selective group of patients. Breakthroughs in understanding the pathogenesis and clinical manifestations are highlighted.

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Spotlight on Migraine with brainstem aura

In this clinical summary, Dr. Kai-Chen Wang of Cheng Hsin General Hospital in Taiwan discusses migraine with brainstem aura, formerly known as “basilar-type migraine.” This is a variant of migraine with the aura symptoms arising from the brainstem or bilateral occipital hemispheres. The onset of the disease usually occurs at the second or third decade. The diagnosis is based on the finding of at least 2 migraine attacks accompanied by at least 2 of the following fully reversible symptoms: dysarthria, vertigo, tinnitus, impaired hearing, double vision, ataxia, and decreased level consciousness. The differential diagnosis should include cerebrovascular diseases, seizures, CADASIL, MELAS, and the pathology of posterior fossa. Despite the lack of data suggesting migraine with brainstem aura as a vasospastic condition, the use of triptans has been considered prohibited. Anticonvulsants and calcium channel blockers may be the drugs of choice in the prophylaxis.

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MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

Spotlight on Migrainous infarction

Migrainous infarction is a rare complication after usual attacks of migraine with aura with a documentation of neuroimaging findings, such as MRI. The incidence of migrainous infarction is very rare, estimated as 3.36 per 100,000 person-years according to the strict criteria proposed by the International Headache Society. It mostly occurs in the posterior circulation and in younger women with a history of migraine with aura. The majority of patients present with visual prolonged aura, and the stroke severity is mild with a good outcome. The pathologic mechanisms responsible for migrainous infarction remain unproven. One recent case report suggests a continuum between migraine aura and stroke by cortical spreading depolarization. In this clinical summary, Dr. Shuu-Jiun Wang of the Neurological Institute at Taipei Veterans General Hospital in Taipei, Taiwan, updates the topic of migrainous infarction, including the new diagnostic criteria proposed by the International Classification of Headache Disorders in 2013.

To view the complete clinical summary, click here.

MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.