Materiały źródłowe

• #1 Migraine With Aura – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554611/

  Migraine syndrome with aura is a prevalent headache disorder affecting approximately 12% of the general population, with nearly 25% of cases experiencing localized sensory symptoms or auras. […] Migraine with aura carries an increased risk of cerebrovascular accidents, prompting timely diagnosis and appropriate treatment. […] Identify the distinctive features and symptoms of migraine with aura to facilitate an accurate and prompt diagnosis. […] Implement evidence-based diagnostic criteria and guidelines in assessing and diagnosing migraine with aura, ensuring consistency and accuracy in clinical practice. […] The diagnostic criteria established by the International Classification of Headache Disorders, 3rd edition (ICHD-3) include migraine without aura and migraine with aura. […] Migraine With Aura: At least 2 attacks that meet the following criteria: 1 fully reversible aura symptoms: Visual, Sensory, Speech, Language, Motor, Brainstem, Retinal.

• #2 Migraine and Aura | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/migraine-and-aura/

  Migraine is a common and disabling condition reported in approximately 12% of the population. […] Migraine with aura occurs in 25-30% of migraineurs. […] People with new or never-evaluated aura should be carefully assessed by their doctor for an underlying cause, as aura can mimic other conditions such as transient ischemic attack, stroke or seizures. It is also important to be assessed so as to confirm what sub-type of aura you have as different aura types have different treatment recommendations. […] Please refer to the International Classification of Headache Disorders 3rd edition (beta version) website for more information on the criteria used to diagnosis migraine with aura: https://www.ichd-3.org/1-migraine/1-2-migraine-with-aura/ […] Anyone presenting with new or never-evaluated aura-like symptoms should be assessed by their doctor to ensure that they do not have any underlying condition that may mimic aura.

• #3 Migraine With Aura – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554611/

  Migraine syndrome with aura is a prevalent headache disorder affecting approximately 12% of the general population, with nearly 25% of cases experiencing localized sensory symptoms or auras. […] Migraine with aura carries an increased risk of cerebrovascular accidents, prompting timely diagnosis and appropriate treatment. […] Identify the distinctive features and symptoms of migraine with aura to facilitate an accurate and prompt diagnosis. […] Implement evidence-based diagnostic criteria and guidelines in assessing and diagnosing migraine with aura, ensuring consistency and accuracy in clinical practice. […] The diagnostic criteria established by the International Classification of Headache Disorders, 3rd edition (ICHD-3) include migraine without aura and migraine with aura. […] Migraine With Aura: At least 2 attacks that meet the following criteria: 1 fully reversible aura symptoms: Visual, Sensory, Speech, Language, Motor, Brainstem, Retinal.

• #4 Migraine with Aura | American Headache Society

  https://americanheadachesociety.org/resources/primary-care/migraine-with-aura

  Approximately one-third of those with migraine experience aura, a sensory experience that occurs before or during an attack. […] Its important to correctly identify aura because those who have migraine with aura can potentially turn chronic, have a higher risk of stroke, and should have a different treatment plan. […] A team of researchers working in France and the U.S. has demonstrated in a large prospective study that women who experience migraine with aura are at greater risk of all types of stroke including ischemic and hemorrhagic stroke as well as all strokes. […] Here’s what you should know about migraine with aura, how it’s treated and the different types people can experience during a migraine attack.

• #5 1.2 Migraine with aura – ICHD-3

  https://ichd-3.org/1-migraine/1-2-migraine-with-aura/

  1.2 Migraine with aura […] Diagnostic criteria: […] A. At least two attacks fulfilling criteria B and C […] B. One or more of the following fully reversible aura symptoms: […] 1. visual […] 2. sensory […] 3. speech and/or language […] 4. motor […] 5. brainstem […] 6. retinal […] C. At least three of the following six characteristics: […] 1. at least one aura symptom spreads gradually over ≥5 minutes […] 2. two or more aura symptoms occur in succession […] 3. each individual aura symptom lasts 5-60 minutes […] 4. at least one aura symptom is unilateral […] 5. at least one aura symptom is positive […] 6. the aura is accompanied, or followed within 60 minutes, by headache […] D. Not better accounted for by another ICHD-3 diagnosis. […] Comments: […] Many patients who have migraine attacks with aura also have attacks without aura; they should be coded as both 1.2 Migraine with aura and 1.1 Migraine without aura.

• #6 Migraine Visual Aura & Other Visual Phenomena

  https://practicalneurology.com/diseases-diagnoses/headache-pain/migraine-visual-aura-other-visual-phenomena/31901/

  Visual disturbances, transient or continuous, are associated with a variety of headache disorders, including migraine with visual aura, retinal migraine, visual snow syndrome (VSS), and Alice in Wonderland syndrome (AWS). […] The prevalence of aura is estimated to be up to 33% in people with migraine. […] Visual auras are most common, occurring in approximately 98% of persons with a diagnosis of migraine with aura. […] Migraine with aura is formally defined by the International Classification of Headache Disorders, 3rd edition (ICHD-3) as recurrent attacks of gradual symptoms of reversible visual, sensory, or central nervous system symptoms lasting minutes and followed by headache and migraine symptoms. […] The diagnostic criteria require at least 2 attacks with 1 or more fully reversible aura symptoms, and at least 3 of the following features: 1) aura spreading gradually over 5 minutes; 2) 2 or more auras occurring in succession; 3) aura symptoms lasting 5 to 60 minutes; 4) unilateral aura; 5) positive aura; or 6) aura accompanied or followed by a headache within 60 minutes.

• #7 Diagnostic criteria – GPnotebook

  https://gpnotebook.com/pages/neurology/classical-migraine/diagnostic-criteria

  At least two attacks that meet the following three criteria: One or more of the following fully reversible aura symptoms: Visual, Sensory, Speech, language, or both, Motor, Brain stem, Retinal. […] At least three of the following six characteristics: At least one aura symptom spreading gradually over a period =5 minutes, Two or more aura symptoms occurring in succession, Each aura symptom lasting 560 minutes, At least one unilateral aura symptom, At least one positive aura symptom, Headache accompanying the aura or following the aura within 60 minutes. […] Not better accounted for by another ICHD-3 diagnosis.

• #8 1.2 Migraine with aura – ICHD-3

  https://ichd-3.org/1-migraine/1-2-migraine-with-aura/

  Field testing has compared the diagnostic criteria for 1.2 Migraine with aura in the main body of ICHD-3 beta with those for A1.2 Migraine with aura in the Appendix. The latter performed better in distinguishing migraine with aura from transient ischaemic attacks. These are now adopted in ICHD-3, which no longer has Appendix criteria for this disorder. […] The aura is the complex of neurological symptoms that occurs usually before the headache of 1.2 Migraine with aura, but it may begin after the headache phase has commenced, or continue into the headache phase. […] Migraine aura is sometimes associated with a headache that does not fulfil criteria for 1.1 Migraine without aura, but this is still regarded as migraine headache because of its relation to the aura. In other cases, migraine aura may occur without headache.

• #9 Migraine With Aura – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554611/

  No specific diagnostic test is available for migraine. The patient’s clinical history and physical examination determine the necessity for testing. […] Neuroimaging is unnecessary for stable patients who meet the diagnostic criteria for migraine. However, if neuroimaging is warranted, magnetic resonance imaging (MRI) is the preferred imaging study. […] Migraine is diagnosed clinically based on symptoms, including unilateral headaches, nausea, photophobia, and phonophobia. Auras may not always precede headaches.

• #10 Diagnosing Migraine | NYU Langone Health

  https://nyulangone.org/conditions/migraine/diagnosis

  Migraine pain may intensify with movement or physical activity. […] An aura is a physiological warning sign that a migraine is about to start. […] An aura can occur before or at the beginning of the head pain, and it can last from 15 minutes to 1 hour. […] To determine if migraines are causing your pain, neurologists at NYU Langone ask about your symptoms, focusing on the frequency, intensity, duration, location, and any known triggers. […] A careful review of your symptoms can help your doctor to determine the type of migraine you’re experiencing and if an underlying condition could be the cause. […] Your doctor may use one or more of the following tests to arrive at the most accurate diagnosis. […] The neurological examination is done to help determine whether the migraines originate from a brain tumor or blood clot in the brain, or to rule out the possibility that another condition may be causing your symptoms.

• #11 Migraine with aura – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/diagnosis-treatment/drc-20352077

  Your doctor might diagnose the migraine with aura based on your signs and symptoms, your medical and family history, and a physical exam. […] If your aura isn’t followed by head pain, your doctor might recommend certain tests to rule out more-serious conditions, such as a transient ischemic attack (TIA). […] Assessments might include: […] A thorough eye exam, done by an eye specialist (ophthalmologist), can help rule out eye problems that might be causing visual symptoms. […] This X-ray technique produces detailed images of your brain. […] This diagnostic imaging procedure produces images of your internal organs, including your brain. […] Your doctor might refer you to a doctor who specializes in nervous system disorders (neurologist) to rule out brain conditions that could be causing your symptoms.

• #12 Migraine With Aura: Types, Symptoms, Causes, and Treatment

  https://www.webmd.com/migraines-headaches/what-is-a-migraine-with-aura

  Migraine with aura is a condition that usually includes intense headaches along with sensory disruptions like dizziness, ringing in your ears, zigzag lines in your vision, or sensitivity to light. […] About 25%-30% of people with migraine have auras. […] Your doctor will do a physical exam and check your muscles, reflexes, speech, and senses. They’ll likely ask questions about your symptoms and health history, such as: Do other family members have migraine or other kinds of headaches? […] Your doctor may do an eye exam to check whether vision issues might be causing your aura symptoms. Imaging tests like CT scans and MRIs can help rule out other possible causes of aura symptoms such as a transient ischemic attack (ministroke).

• #13 What Is a Migraine Aura? All About Migraines With Aura | Excedrin

  https://www.excedrin.com/headache-and-migraine-academy/migraines/migraine-types/aura-migraines/

  The cause of migraines with aura isnt fully understood. Like migraines without aura they are considered a neurovascular disorder. […] You should also consult a doctor when you first experience aura symptoms, as some of these can also be caused by a stroke, retinal tear or other serious conditions. […] The treatment for migraine with aura is the same as for migraine without aura. It is generally recommended to take your migraine medication at the first sign of migraine symptoms. […] In addition to pain-relieving medications designed to stop migraine symptoms once they start, your doctor may recommend you take preventative drugs to try to reduce your migraine frequency and severity over time. […] Making adjustments in your lifestyle can sometimes help to reduce the frequency of migraines.

• #14 1.2 Migraine with aura – ICHD-3

  https://ichd-3.org/1-migraine/1-2-migraine-with-aura/

  Patients often find it hard to describe their aura symptoms, in which case they should be instructed to time and record them prospectively. The clinical picture then becomes clearer. Common mistakes are incorrect reports of lateralization, of sudden rather than gradual onset and of monocular rather than homonymous visual disturbances, as well as of duration of aura and mistaking sensory loss for weakness. After an initial consultation, use of an aura diary may clarify the diagnosis. […] The previously defined syndromes, migraine with prolonged aura and migraine with acute-onset aura, have been abandoned. It is not rare for aura to last more than one hour but, in most such cases, patients have at least two of the other characteristics of criterion C. Even when most of a patient’s attacks do not fulfil criterion C, it is usual that other attacks fulfil criteria for one of the recognized subtypes or subforms of 1.2 Migraine with aura, and this should be the diagnosis. The few other cases should be coded to 1.5.2 Probable migraine with aura, specifying the atypical feature (prolonged aura or acute onset aura) in parenthesis. The diagnosis is usually evident after a careful history alone, although there are rare secondary mimics including carotid dissection, arteriovenous malformation and seizure.

• #15 Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome

  https://www.mdpi.com/2075-4418/13/2/252

  History taking of VASs should focus on all the following symptom features: frequency, consistency, uniformity, duration, timing, temporal relation to the headache, characteristics of the visual phenomena, location in the visual field, laterality (one eye/both eyes) progression (modification of visual disturbance), direction of aura spreading in the visual field. Importance should also be given to features of previous headache attacks, in order to establish a diagnosis of episodic or chronic migraine and the presence of non-visual aura symptoms. […] Although migraine is arguably the most common cause of concurrent neurologic symptoms and headache, it is not the only setting in which this occurs. Care should be taken in the evaluation of neurologic symptoms of migraine in order to exclude serious and potentially life-threatening conditions, such as cerebrovascular disease, epilepsy, idiopathic intracranial hypertension (IIH), and psychiatric disorders.

• #16 Migraine Visual Aura & Other Visual Phenomena

  https://practicalneurology.com/diseases-diagnoses/headache-pain/migraine-visual-aura-other-visual-phenomena/31901/

  The workup for people presenting with migraine with aura, a clinical diagnosis, starts with a thorough history, followed by a comprehensive neurologic and ophthalmic evaluation. […] Additional evaluation is not indicated for those presenting with symptoms meeting criteria for migraine with aura who have no findings on neurologic examination. […] If visual symptoms raise concern for a vascular etiology, then the patient should be evaluated with head imaging (either a CT with and without contrast or MRI). […] Persistent migraine aura without infarction (PMA) is defined under complications of migraine in the ICHD-3, whereas migraine aura status is an appendix diagnosis. […] The criteria for migraine aura status requires at least 3 auras over 3 days vs at least 1 week for a diagnosis of PMA.

• #17 Migraine Headache Workup: Approach Considerations, Indications for Neuroimaging, Lumbar Puncture Indications

  https://emedicine.medscape.com/article/1142556-workup

  Migraine is a clinical diagnosis. Diagnostic investigations are performed for the following reasons: […] The choice of laboratory and/or imaging studies is determined by the individual presentation. For example, in an older person with compatible findings (eg, scalp tenderness), measurement of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) may be appropriate to rule out temporal/giant cell arteritis. Visual field testing should be performed in patients with persistent visual phenomena. […] A 2013 study suggested that high peripheral blood levels of calcitonin gene-related peptide (CGRP), a neurotransmitter that causes vasodilation, can aid in the diagnosis of chronic migraine by serving as a biomarker for permanent trigeminovascular activation. […] Neuroimaging is not necessary in patients with a history of recurrent migraine headaches and a normal neurologic examination. Neuroimaging is indicated for any of the following: […] Indications for LP include the following: […] Neuroimaging (CT or MRI scan) should precede LP to rule out a mass lesion and/or increased intracranial pressure.

• #18 Migraine Aura: What Is It, Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/22131-migraine-aura

  Migraine aura is considered a warning stage that sometimes occurs before the onset of a migraine headache. […] To rule out more serious conditions, such as a transient ischemic attack (TIA) or mini stroke, your healthcare provider will perform a physical examination. They may also run certain tests to confirm your diagnosis. These tests may include: […] An eye exam. This test helps rule out any eye conditions that could be causing aura symptoms. […] A CT (computed tomography) scan of your head. This scan takes detailed images of your brain. […] Magnetic resonance imaging (MRI). This test uses magnets and radio waves to capture images of your tissues, organs and structures inside of your body.

• #19 Diagnosis of Migraine Headache | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/1215/p2087.html

  Imaging is recommended for patients with high-risk features such as acute thunderclap headache; abnormal neurologic examination findings; aura; vomiting, if not part of the patients usual migraine pattern; headache aggravated by exertion or Valsalva maneuver; or a nonclassic pattern of migraine, cluster, or tension headache. […] Imaging also should be considered in patients with new-onset headache, change in character of headache, or adult-onset migraine.

• #20 Migraine: What It Is, Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches

  A healthcare provider will diagnose a migraine after a physical exam and neurological exam. Theyll also learn more about your medical history and biological family health history. Your provider may ask you questions to learn more about your symptoms, including: […] Your provider may also order blood tests and imaging tests (such as a CT scan or an MRI) to make sure there arent any other causes for your headache. An electroencephalogram (EEG) may help your provider rule out other conditions. […] If you think you have a migraine, discuss your symptoms with a primary care physician (PCP) first. They can diagnose migraine headaches and start treatment. Your PCP may refer you to a headache specialist or a neurologist.

• #21 Diagnosing Migraine | NYU Langone Health

  https://nyulangone.org/conditions/migraine/diagnosis

  A doctor may order an MRI scan to look for other conditions that can cause headaches, such as a tumor or abscess, which is a collection of pus that has formed in response to an infection. […] MRA scans allow your doctor to see if blood vessels are blocked by a clot or if there are any other factors that may be restricting or increasing blood flow and triggering headaches.

• #22 Migraine Visual Aura & Other Visual Phenomena

  https://practicalneurology.com/articles/2022-may/migraine-visual-aura-other-visual-phenomena

  The workup for people presenting with migraine with aura, a clinical diagnosis, starts with a thorough history, followed by a comprehensive neurologic and ophthalmic evaluation. […] Additional evaluation is not indicated for those presenting with symptoms meeting criteria for migraine with aura who have no findings on neurologic examination. […] If visual symptoms raise concern for a vascular etiology, then the patient should be evaluated with head imaging (either a CT with and without contrast or MRI). […] Very rarely, if there is difficulty discerning occipital lobe epilepsy from a migraine with aura, a routine EEG may be beneficial in addition to neuroimaging.

• #23 Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome

  https://www.mdpi.com/2075-4418/13/2/252

  Based on these often-challenging differential diagnoses, brain magnetic resonance imaging should be requested in all forms of MwA that present one or more atypical features, and this should be accompanied by electroencephalography in the case when epilepsy is suspected and/or by a full ophthalmological examination when symptoms are fully lateralized. Further, with negative symptoms such as transient visual obscuration and blurring, secondary causes of headache such as IIH should be excluded. […] The majority of studies addressing the efficacy of different migraine treatments have included mixed populations of patients with or without aura, while treatment effect based on aura has been rarely reported. Under these circumstances, the current guidelines for migraine do not establish any treatment distinction regarding patients with or without visual aura. However, some studies also indicate that MwA might respond differently to acute or preventive therapies as compared to migraine without aura.

• #24 Migraine with aura – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20352072

  Migraine with aura (also called classic migraine) is a recurring headache that strikes after or at the same time as sensory disturbances called aura. […] See your doctor immediately if you have new signs and symptoms of migraine with aura, such as temporary vision loss, speech or language difficulty, and muscle weakness on one side of your body. Your doctor will need to rule out more-serious conditions, such as a stroke. […] There is evidence that the migraine aura is due to an electrical or chemical wave that moves across the brain. The part of the brain where the electrical or chemical wave spreads determines the type of symptoms you might experience. […] The most common type of aura is visual aura, which occurs when a wave of electrical activity spreads through the visual cortex and causes visual symptoms. […] People who have migraine with aura are at a mildly increased risk of stroke.

• #25 Migraine and Aura | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/migraine-and-aura/

  Migraine is a common and disabling condition reported in approximately 12% of the population. […] Migraine with aura occurs in 25-30% of migraineurs. […] People with new or never-evaluated aura should be carefully assessed by their doctor for an underlying cause, as aura can mimic other conditions such as transient ischemic attack, stroke or seizures. It is also important to be assessed so as to confirm what sub-type of aura you have as different aura types have different treatment recommendations. […] Please refer to the International Classification of Headache Disorders 3rd edition (beta version) website for more information on the criteria used to diagnosis migraine with aura: https://www.ichd-3.org/1-migraine/1-2-migraine-with-aura/ […] Anyone presenting with new or never-evaluated aura-like symptoms should be assessed by their doctor to ensure that they do not have any underlying condition that may mimic aura.

• #26 Migraine Visual Aura & Other Visual Phenomena

  https://practicalneurology.com/diseases-diagnoses/headache-pain/migraine-visual-aura-other-visual-phenomena/31901/

  Both these diagnoses should only be considered after vascular symptomatic aura etiologies (eg, posterior reversible encephalopathy syndrome [PRES], vascular dissections, reversible cerebral vasoconstriction syndrome [RCVS], and cerebral ischemia) have been excluded by MRI including vascular imaging. […] Analysis suggests, however, that at least 11% and possibly up to 30% of persons with migraine with aura have an aura lasting more than 1 hour, leading clinicians to suggest improved diagnostic clarity is needed to address this prolonged aura.

• #27 Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome

  https://www.mdpi.com/2075-4418/13/2/252

  History taking of VASs should focus on all the following symptom features: frequency, consistency, uniformity, duration, timing, temporal relation to the headache, characteristics of the visual phenomena, location in the visual field, laterality (one eye/both eyes) progression (modification of visual disturbance), direction of aura spreading in the visual field. Importance should also be given to features of previous headache attacks, in order to establish a diagnosis of episodic or chronic migraine and the presence of non-visual aura symptoms. […] Although migraine is arguably the most common cause of concurrent neurologic symptoms and headache, it is not the only setting in which this occurs. Care should be taken in the evaluation of neurologic symptoms of migraine in order to exclude serious and potentially life-threatening conditions, such as cerebrovascular disease, epilepsy, idiopathic intracranial hypertension (IIH), and psychiatric disorders.

• #28 Transient ischemic attack or migraine with aura? | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2023/10/clinical-review/transient-ischemic-attack-or-migraine-aura

  Migraine or migraine-like symptoms can contribute to a delayed stroke diagnosis. However, migraine with aura is a common stroke mimic and often the basis for acute thrombolytic therapy. It is probably also the reason why many patients are misdiagnosed with a transient ischemic attack. In this clinical review, we explain the factors that could differentiate a transient ischemic attack from a migraine with aura. […] Migraine with aura: the criteria for typical migraine with aura have high sensitivity and high specificity. Migraine with aura is defined as visual, somatosensory, speech, motor (hemiplegic migraine) or brainstem symptoms (migraine with brainstem aura) associated with a migraine attack. The symptoms typically develop gradually (usually over 520 minutes) and the maximum duration is 60 minutes for each individual symptom. […] Clinical assessment of episodes with transient neurological symptoms must be considered in light of supplementary findings and risk profile. Migraine with aura can, in most cases, be distinguished from TIA by the gradual onset of symptoms with typical characteristics, sequence and duration.

• #29 Pediatric Episodic Migraine with Aura: A Unique Entity?

  https://www.mdpi.com/2227-9067/8/3/228

  Migraine headache is a common cause of pain and disability in children and adolescents and is a major contributor to frequently missed school days and limitations in activities. Of children and adolescents with migraine headache, approximately one-third have migraine with aura (MA). The purpose of this review is to highlight the current evidence demonstrating the unique pathophysiology, clinical characteristics, differential diagnosis, co-morbidities, and treatment recommendations and responses for pediatric MA. The International Classification of Headache Disorders (ICHD) distinguishes MA from MO. The defining feature of MA is the presence of aura, which may be present without a headache. When head pain is present, aura typically precedes it, but both features can occur simultaneously. Aura is classified into subtypes and must satisfy specific criteria related to duration, laterality, and symptom quality. The current diagnostic criteria from the ICHD-3 for MA are outlined in Table 1. These criteria are the same for adult and pediatric patients. Within MA, there are four distinct types: migraine with typical aura, migraine with brainstem aura, hemiplegic migraine, and retinal migraine. It is important to highlight the unique features of hemiplegic migraine and migraine with brainstem aura as these are often thought of as more severe forms of migraine which has implications for treatment recommendations. Because focal neurological signs are present in MA, there are important alternative diagnoses to consider including transient ischemic attack (TIA), stroke, and epileptic seizure. Accurately diagnosing MA may prevent unnecessary testing and may prevent patients from being treated with harmful medications that target other conditions. However, inappropriately diagnosing MA when the correct diagnosis is TIA, stroke, or seizure may lead to delays in initiating life-saving therapies. The detailed nature of the ICHD criteria helps to distinguish MA from other entities based on clinical history. The current version of the ICHD-3 criteria was updated from the ICHD-3 beta criteria in 2018 to better distinguish MA from TIA. The update included the addition of “at least one symptom is positive” to the criteria, as positive symptoms are much more common in migraine aura and negative symptoms are more common in TIA and stroke.

• #30 Migraine with brainstem aura – The Migraine TrustVisualV1 – SearchVisualV1 – CrossVisualV1 – Home VisualV1 – CrossVisualV1 – Arrow

  https://migrainetrust.org/understand-migraine/types-of-migraine/migraine-with-brainstem-aura/

  Migraine with brainstem aura should be distinguished from hemiplegic migraine. Hemiplegic migraine causes temporary weakness on one side of the body, usually in the face and arms but may also affect the legs. […] People experiencing migraine with brainstem aura attacks may be considered and investigated for some other conditions such as Meniere’s disease, ischaemic stroke, epilepsy or vestibular disorders affecting the ear causing vertigo. Other conditions will need to be ruled out to receive the appropriate diagnosis and treatment. […] Migraine with aura has a slightly higher risk of stroke than migraine without aura; however, there is no evidence that migraine with brainstem aura has a higher risk of stroke than migraine with typical aura.

• #31 What is Migraine Disorder? We Take A Different Approach

  https://www.migrainedisorders.org/migraine-disorders/

  According to ICHD-3, the diagnostic criteria for MBA is migraine with aura including at least two of the following symptoms: slurred or slow speech (dysarthria), vertigo, ringing in the ears (tinnitus), partial hearing loss (hypoacusis), double vision (diplopia), impaired coordination (ataxia), or decreased level of consciousness.

• #32 Ocular Migraines: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/migraines-headaches/ocular-migraine-basics

  Ocular Migraine Diagnosis: There’s no test that can diagnose ocular migraine. Your doctor will need to rule out other primary headache disorders and conditions that may cause visual symptoms. They may refer you to an ophthalmologist to screen you for eye conditions before they diagnose you. […] Your doctor will likely start by asking about your symptoms and your personal and family medical history. Theyll likely perform a physical exam to assess for other medical issues, such as a stroke that affects blood flow to one of your eyes. […] Other conditions that could cause similar symptoms include: Amaurosis fugax, temporary blindness due to a lack of blood flow to the eye. It can happen because of a blockage in an artery that leads to the eye. […] Ocular migraine and retinal migraine are used interchangeably. The older term is „ocular migraine,” and doctors used it to refer to any migraine that had visual symptoms. They would call a migraine with a visual aura and a retinal migraine an ocular migraine. […] The newer term is „retinal migraine,” and doctors may prefer this term because it specifically refers to the type of migraine where visual symptoms occur in one eye.

• #33 Migraine With Aura | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25145

  Migraine diagnosis relies on a clinical assessment, necessitating a comprehensive history and physical examination. […] The presence of positive visual or sensory symptoms followed by negative symptoms is characteristic of migraine and aids in distinguishing migraine from ischemic events. […] Patients with a migraine equivalent or acephalic migraine develop an aura without a subsequent headache. This variant of migraine presents a unique challenge in diagnosis and management, requiring careful evaluation to differentiate it from other neurological conditions. […] Neuroimaging is unnecessary for stable patients who meet the diagnostic criteria for migraine. However, if neuroimaging is warranted, magnetic resonance imaging (MRI) is the preferred imaging study. […] The occurrence of unilateral facial or limb weakness in the presence of a migraine is termed hemiplegic migraine. […] The presence of amaurosis, temporal artery tenderness in older patients, meningismus, fever, lethargy, jaw claudication, seizure, and mental status changes should prompt consideration of underlying pathology beyond migraine.

• #34 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  The medical history is the mainstay of migraine diagnosis; with the assistance of a range of published aids, a full history should enable systematic application of the criteria set out in the ICHD-3. Physical examination is most often confirmatory and further investigations (for example, neuroimaging, blood samples or lumbar puncture) are occasionally required to confirm or reject suspicions of secondary causes for headache. […] Diagnosis of migraine can also be facilitated by use of screening instruments that evaluate whether a patient’s clinical features suggest migraine. Validated screening instruments include the three-item ID-Migraine questionnaire and the five-item Migraine Screen Questionnaire (MS-Q). The ID-Migraine questionnaire has a sensitivity of 0.81, a specificity of 0.75 and a positive predictive value of 0.93 when compared with ICHD-based diagnosis by a headache specialist. The MS-Q instrument has a sensitivity of 0.93, a specificity of 0.81 and a positive predictive value of 0.83.

• #35 Migraine Headache: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1142556-overview

  The diagnosis of migraine is clinical in nature, based on criteria established by the International Headache Society. A full neurologic examination should be performed during the first visit, to exclude other disorders; the findings are usually normal in patients with migraine. Neuroimaging is not necessary in a typical case, but other diagnostic investigations may be indicated to guide management. […] A screening tool called the ID-CM may be useful in diagnosis. The ID-CM is a 12-item screening tool for chronic migraine that has a sensitivity of 82% and a specificity of 87% compared with semi-structured clinical interviews.

• #36 Understanding Migraine Tests and Diagnosis Doctor Q&A — Migraine Again

  https://www.migraineagain.com/migraine-tests-diagnosis/

  Keeping a headache diary can help your physician understand what you’re experiencing. In this diary, you can note the characteristics of your attacks, such as duration, symptoms, and frequency. […] Because migraine is so widespread, any primary care provider may be able to diagnose migraine. More frequent or complicated migraine presentations may require the help of a neurologist or headache specialist. […] There is no blood test of any kind that is helpful for diagnosing migraine or identifying triggers, and that includes blood tests for genetic testing. […] The purpose of imaging tests such as magnetic resonance imaging (MRI) or a CT scan in a patient with headache pain is not to diagnose migraine but to diagnose something else besides migraine. […] Migraine diagnosis is based upon review of medical history and a clinical evaluation, including neurological examination and assessment of a patient’s symptoms, such as nausea, photophobia, phonophobia, and pain characteristics.

• #37 Migraine with Aura | LloydsPharmacy Online Doctor UK

  https://onlinedoctor.lloydspharmacy.com/uk/lifestyle-advice/migraine-with-aura

  Migraine with aura: how to get diagnosed? […] If you think you’re experiencing migraines with aura, your first step should be talking to your doctor. […] At your appointment, your doctor will ask you about the auras or warning signs you’ve had, like flashing lights or zigzag patterns. They’ll also ask if anyone else in your family gets migraines to see if theres a genetic component. […] Your doctor might want to give you a physical examination, checking your reflexes, balance, and senses to rule out any other causes for your symptoms. […] Before giving you a diagnosis, your doctor might ask you to keep a headache diary for a couple of weeks. You might need to jot down when you get your migraines, what you were doing at the time and where, and what the warning signs were. This can help spot patterns and triggers and make it easier to give you a diagnosis.

• #38 Migraine | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/migraine/

  Theres no specific test to diagnose migraine. Your GP must identify a pattern of recurring headaches along with the associated symptoms. […] Migraine headaches can be unpredictable, sometimes occurring without the other symptoms. Getting an accurate diagnosis can take time. […] Your GP might do a physical examination and check your vision, co-ordination, reflexes and sensations. These will help rule out some other possible underlying causes of your symptoms. […] To help with the diagnosis, it can be useful to keep a diary of your migraine attacks for a few weeks. […] Your GP may decide to refer you to a neurologist (a specialist in conditions affecting the brain and nervous system). Theyll do further assessments and offer treatment if: a diagnosis is unclear or you experience significant migraine headaches that arent being controlled by your current treatment.

• #39 Migraine and Aura | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/migraine-and-aura/

  Treatment of migraine with aura should consist of: […] Migraine with aura slightly increases the risk of having a stroke so women who have migraine with aura need to think carefully about the potential risks associated with birth control pills that contain estrogen or hormone replacement therapy. […] Receiving a formal migraine diagnosis is the first milestone when working with your doctor to identify a personalized and effective treatment plan. […] It will be crucial to have access to reliable resources on migraine as you work to manage this disease.

• #40 Migraine and stroke | Stroke Association

  https://www.stroke.org.uk/stroke/managing-risk/migraines-and-stroke

  Migraines have not been shown to cause stroke, but if you have migraine with aura, you have a very slightly higher risk of stroke. […] If you have migraine with aura, you are about twice as likely to have an ischaemic stroke in your lifetime compared to those without migraine. […] Taking the combined oral contraceptive pill (combi pill) increases the risk of a stroke in women who have migraine with aura. […] Some health conditions are linked to migraine. For example, CADASIL (a rare genetic disorder), and the auto-immune conditions antiphospholipid syndrome and lupus, are linked to a higher risk of stroke, and people with these conditions are also more likely to have migraine. […] Migraine is diagnosed by piecing together information about your symptoms and identifying patterns over time.

• #41 Migraine with Aura: Symptoms, Visual Disturbances, and Management

  https://headacheaustralia.org.au/migraine-aura/

  Migraine aura refers to a collection of symptoms that you might experience before or during a migraine attack. These symptoms can affect your vision, senses, or neurological function. […] You will receive a diagnosis for migraine with aura by seeing your general practitioner or neurologist. Migraine aura is diagnosed according to criteria in the ICHD-3 (International Classification of Headache Disorders), which is developed by the International Headache Society. […] You will be diagnosed if you have at least two attacks that involve one or more of the following fully reversible aura symptoms: Visual, Sensory, Speech and/or language, Motor, Brainstem, Retinal. […] An aura diagnosis should always be confirmed by a medical professional to rule out any serious health issues. […] If you need to find a neurologist, you can use our Doctor Directory to find a practitioner that specialises in migraine and headache.

• #42 How to Know if You Have Migraine With Aura — Migraine Again

  https://www.migraineagain.com/how-to-know-if-you-have-migraine-with-aura/

  In fact, more than half of people with migraine never actually receive a migraine diagnosis. Given the lack of headache specialists in the United States, it is not surprising. […] With only 500 certified headache specialists to treat more than 39 million people with migraine, the chances of being misdiagnosed by a primary care physician, ENT provider, gynecologist, or neurologist are high.

• #43 2025 ICD-10-CM Diagnosis Code G43.1: Migraine with aura

  https://www.icd10data.com/ICD10CM/Codes/G00-G99/G40-G47/G43-/G43.1

  G43.1 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. […] The 2025 edition of ICD-10-CM G43.1 became effective on October 1, 2024. […] This is the American ICD-10-CM version of G43.1 – other international versions of ICD-10 G43.1 may differ. […] A subtype of migraine disorder, characterized by recurrent attacks of reversible neurological symptoms (aura) that precede or accompany the headache. Aura may include a combination of sensory disturbances, such as blurred vision; hallucinations; vertigo; numbness; and difficulty in concentrating and speaking. Aura is usually followed by features of the common migraine, such as photophobia; phonophobia; and nausea. (international classification of headache disorders, 2nd ed. Cephalalgia 2004: suppl 1)

• #44 ICD-10-CM/PCS MS-DRG v37.0 Definitions Manual

  https://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0076.html

  G43101 Migraine with aura, not intractable, with status migrainosus […] G43109 Migraine with aura, not intractable, without status migrainosus […] G43111 Migraine with aura, intractable, with status migrainosus […] G43119 Migraine with aura, intractable, without status migrainosus […] G43501 Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus […] G43509 Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus […] G43511 Persistent migraine aura without cerebral infarction, intractable, with status migrainosus […] G43519 Persistent migraine aura without cerebral infarction, intractable, without status migrainosus […] G43601 Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus

• #45 ICD-10-CM/PCS MS-DRG v37.0 Definitions Manual

  https://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0076.html

  G43609 Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus […] G43611 Persistent migraine aura with cerebral infarction, intractable, with status migrainosus […] G43619 Persistent migraine aura with cerebral infarction, intractable, without status migrainosus

• #46

  https://link.springer.com/article/10.1007/s10072-013-1372-2

  Migraine with aura (MWA) is a common headache, characterized by short-lasting neurological signs preceding an headache attack with migraine characteristics. […] Aim of this study was to compare the time necessary to obtain a correct diagnosis in MWA and MWoA patients. […] Diagnostic delay was significantly different (p 0.05), resulting lower in patients affected by MWA than in those with MWoA. In fact, subjects affected by MWA had a mean diagnostic delay of 6.70 years (SE 1.5), while patients affected by MWoA had a mean interval of 10.7 years (SE 1.20). Patients affected by MWA present a significant lower delay for the formulation of a correct diagnosis with respect to subjects with MWoA. […] Our findings show that the patients affected by MWA have a significantly lower delay in diagnosis formulation with respect to patients with MWoA. […] All these elements can contribute to a more rapid diagnostic pathway for MWA with respect to MWoA and, consequently, to a better disease management. […] The delay in migraine diagnosis remains one of the most relevant problems for headache specialists.

• #47 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Migraine-Diagnosis.aspx

  Migraines are commonly diagnosed based on symptoms, since there are no specific tests to detect and confirm this condition. […] To be satisfied that a person suffers from migraines, a doctor needs to establish a pattern of recurring headaches. […] These headaches may be accompanied by symptoms such as nausea and vomiting or preceded by warning signs (called aura) such as vision problems or stiffness in the neck. […] On the other hand, migraines can occur unpredictably and in the absence of any other symptoms, which can make diagnosis difficult to confirm. […] Furthermore, a person can suffer from a silent headache which is characterized by symptoms of migraine such as nausea and aura but no actual headache. This can also be a challenge to diagnose. […] Some of the steps taken in the diagnosis of migraine include:

• #48 Migraine – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/headache/migraine

  Diagnosis of migraine is based on characteristic symptoms and a normal physical examination, which includes a thorough neurologic examination. […] Patients with characteristic symptoms and no red flag findings do not require testing. Patients with red flag findings often require testing, including MRI and sometimes lumbar puncture. […] Common diagnostic errors include the following: Not realizing that migraine often causes bilateral pain and is not always described as throbbing. […] Mistaking migraine with aura for a transient ischemic attack, especially when the aura occurs without headache, in older adults. […] Several unusual disorders can mimic migraine with aura.

• #49 How to Know if You Have Migraine With Aura — Migraine Again

  https://www.migraineagain.com/how-to-know-if-you-have-migraine-with-aura/

  It’s essential you know which of the 7 Types of Migraine you have by getting an accurate diagnosis. Effective treatment depends on the correct diagnosis that a headache specialist or qualified doc can provide. […] The diagnosis of migraine with aura requires that you’ve had two attacks with aura symptoms, the symptoms begin and progress slowly, and they resolve spontaneously in an hour or less, says Andrew Charles, professor of neurology and director of the UCLA Goldberg Migraine Program. […] When migraine is properly diagnosed, doctors use a classification system known as the International Classification of Headache Disorders, or ICHD-3, to distinguish between different migraine types. […] Unfortunately for many people with migraine, getting accurately diagnosed proves challenging. […] In many cases migraine is misdiagnosed as sinusitis, causing patients to miss out on proper migraine treatment and relief.

• #50 Migraine Visual Aura & Other Visual Phenomena

  https://practicalneurology.com/articles/2022-may/migraine-visual-aura-other-visual-phenomena

  Visual disturbances, transient or continuous, are associated with a variety of headache disorders, including migraine with visual aura, retinal migraine, visual snow syndrome (VSS), and Alice in Wonderland syndrome (AWS). […] Visual auras are most common, occurring in approximately 98% of persons with a diagnosis of migraine with aura. […] Migraine with aura is formally defined by the International Classification of Headache Disorders, 3rd edition (ICHD-3) as recurrent attacks of gradual symptoms of reversible visual, sensory, or central nervous system symptoms lasting minutes and followed by headache and migraine symptoms. […] The diagnostic criteria require at least 2 attacks with 1 or more fully reversible aura symptoms, and at least 3 of the following features: 1) aura spreading gradually over 5 minutes; 2) 2 or more auras occurring in succession; 3) aura symptoms lasting 5 to 60 minutes; 4) unilateral aura; 5) positive aura; or 6) aura accompanied or followed by a headache within 60 minutes.

• #51 Diagnosis and management of migraine in ten steps | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-021-00509-5

  Differential diagnoses for migraine include other primary headache disorders and some secondary headache disorders. Distinction from other primary headache disorders is a prerequisite for successful management, whereas distinction from secondary headache disorders is crucial because some of these disorders are serious and potentially life-threatening. […] The only role for neuroimaging in the diagnosis of headache is to confirm or exclude causes of secondary headache that are suspected on the basis of red flags in the medical history and/or physical examination. Otherwise, neuroimaging is not only rarely necessary in the diagnostic work-up of migraine but can be harmful, as it can involve exposure to ionizing radiation.

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