Aura Symptoms Are Variable in Patients With Migraine

­Patients with migraine often report multiple symptoms of visual and nonvisual aura, according to research presented at the Congress of the European Academy of Neurology 2016.

Migraines can present with a variety of clinical features. One of the reported yet previously unstudied manifestations is migraine aura. The researchers aimed to uncover how migraine aura differs between patients and between migraine events in the same patient.

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To conduct their study, the researchers examined 267 patients who presented with clinical features of migraine with aura in 16 centers in the United States and were enrolled in a large clinical trial.

The researchers then compared retrospective migraine attack characteristics reported at baseline with those reported prospectively in the trial.

At baseline, patients reported a median of 2 visual aura symptoms each, with a range of 1 to 5. Throughout the trial, patients reported 861 migraine attacks starting with aura and often reported multiple visual and nonvisual symptoms.

The researchers determined that the most common visual symptoms were dots or flashing lights (70%), wavy or jagged lines (47%), blind spots (42%), and tunnel vision (27%). 

The most common reported nonvisual symptoms of aura were numbness or pins and needles (30%), difficulty recalling or speaking (26%), changes in smell (19%), and changes in taste or touch (14%).

Although nausea is a main diagnostic symptom of migraine, only about half of the patients reported nausea.

“These findings are consistent with variable involvement of different brain regions during a migraine attack,” the researchers concluded.

“The variable occurrence of nausea, and phonophobia in conjunction with photophobia, both defining features of migraine, may be an important consideration in designing clinical studies of migraine in which prospectively recorded attacks are diagnosed based on these clinical features.”

—Amanda Balbi

Reference:

Hansen JM, Goadsby PJ, Charles AC. Variability of clinical features in attacks of migraine with aura. Cephalalgia. 2016;36(3):216-224. http://cep.sagepub.com/content/36/3/216.full. Accessed June 6, 2016.