![]() ![]() Follow up visits were arranged with a neurologist for patients who had completed three recordings and the content of their diaries was discussed, specifically to verify if the described symptoms i) were typical of previous auras experienced by the patient ii) were not premonitory symptoms (i.e. The diary allowed the patients to - describe each visual (VS), sensory (SS) and dysphasic (DS) aura symptom in their own words, highlight the main characteristics of their migraine and record the duration of the aura symptoms and headache. Patients were asked to prospectively record the characteristics of three consecutive attacks in an ad hoc aura diary. Inclusion criteria were: patients suffering from migraine with aura for at least 1 year which met the ICHD-2 criteria for 1.2.1 typical aura with migraine headache,1.2.2, typical aura with non-migraine headache, 1.2.3 typical aura without headache, excluding point 3 of C criteria (“each individual aura symptom lasts 5-60 minutes”) and where only one of point C1 or C2 had to be verified to fulfill C criteria ii) age between 16 and 65 years.Įxclusion criteria were: i) hemiplegic migraine ii) brainstem aura iii) pregnancy iv) variation of the characteristics of aura and/or headache in the last 6 months: v) patients with > 2 vascular risk factors vi) history of myocardial infarction and/or transitory ischemic attack (TIA) and/or stroke and/or others thrombophilic disturbances vii) patients with episodes that are not clearly differentiated from other disturbances (TIA, seizures).Įach patient was diagnosed with migraine with aura by a neurologist of the headache center, who then confirmed the patient met the inclusion and exclusion criteria before being included in the study. Mondino” National Neurological Institute, Pavia, Italy and REC-Central, Trondheim, Norway). ![]() All patients provided signed informed consent and ethical approval was sought from local ethics committees (“C. The recruitment period was between October 2012 and July 2014, with the completion of follow-up in May 2015. We enrolled 224 successive patients in the headache centers of Pavia and Trondheim (198 and 26 respectively) who suffered from migraine with aura. Preliminary results was presented during the International Headache Congress, Vancouver, Canada, 2017. This study forms part of a larger research dedicated to the evaluation of the temporal and qualitative aspects of migraine with aura, whose results have been partly published in 2 previous reports. We present a prospective study focusing on the frequency of occurrence and characteristics of PA. In the literature we could find only a retrospective study conducted in pediatric patients, one case series reported in the abstract form to a congress and few case reports. So far there are no systematic studies assessing prospectively in adults i) the prevalence of PA and ii) the clinical characteristics of PA. ![]() We feel that a detailed description of the phenotype of the attacks it is important for achieving a more evidence-based nosographic framing of migraine with aura. The term “probable” used in such classification indicates suspicion as to whether the symptom is migraine aura and from our clinical experience we feel it does not help to categorise auras of a longer duration. Those lasting more than 60 min and less than 7 days are classified as ‘probable migraine with aura (prolonged aura)’. Ĭurrently a prolonged non-hemiplegic migraine with aura (NHMA) is classified as ‘persistent aura without infarction’ if the duration is equal or longer than 7 days. However the subsequent two versions of the ICHD removed PA from the classification. The first version of the ICHD included migraine with prolonged aura (PA) and defined it as migraine with one or more aura symptoms lasting more than 60 min and less than a week, occurring in the presence of normal neuroimaging findings. However these symptoms can last longer in a rare subtype of migraine with aura, namely hemiplegic migraine, which is not discussed in this paper. Īll of the first three editions of the International Classification of Headache Disorders (ICHD) have considered the individual symptoms of aura to be typical if the duration is more than five and less than 60 min. Aura comprises completely reversible visual, sensory, or language symptoms (occurring respectively in 98, 36 and 10% of auras). Worldwide migraine is the third most common disorder and around 30% of sufferers experience migraine auras. They do not differ from the other auras (even when their duration extends to 2 and/or 4 h) with the exception of a higher number of non-VS. There is limited literature on prolonged aura (PA - defined as an aura including at least one symptom for > 1 h and 2 h ( n = 23) or > 4 h ( n = 14) with the the others ( n = 193 and n = 202 respectively).
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