Migraine Aura

Migraine aura is a fully reversible condition that either precedes or commences with the onset of head pain.

It affects up to 20% of migraineurs, and in some rarer cases my appear without headache.

It is now understood to be related to a phenomenon called “cortical spreading depression”. This tsunami of decreased blood flow causes decreased nerve activity in the brain. It begins in the occipital lobe (visual cortex) and spreads to the front quite slowly (estimated 3mm/minute).
First observed in animals in the 1940’s, recent MRI and PET scan studies show it is a common feature of aura.

Is this the brains way of limiting the overactivity coming from the trigeminocervical nucleus? A lot remains to be understood about the relationship between different aspects of migraine.

Typical aura may involve:

  • Visual disturbance: bright flashing lights, zig zag lines, scotoma (loss of part of visual
    field/blind spot), difficulty focussing
  • Paraesthesia – pins and needles/tingling, numbness
  • Parosmia – altered smell
  • Dysarthria – difficulty speaking
  • Dysphagia – difficulty swallowing
  • Dysgeusia – altered taste
  • Hypokinesia – decreased muslce function
  • Paramnesia – deja vu, Jamaiv vu
  • Auditory hallucinations – tinnitus, buzzing
  • Altered cognitive function

It should be noted that if any of these symptoms appear for the first time, or they are regular features but do not fully resolve you should seek and assessment with a medical practitioner. However rare, any of these can be signs of more significant pathology and appropriate investigation is warranted.

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