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Migraine with and without headache.

Thomas Freedom1, Walter M Jay

  • 1Departments of Neurology, Loyola University Medical Center, Maywood, IL, USA. tfreedom@enh.org

Seminars in Ophthalmology
|October 30, 2004
PubMed
Summary
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Transient visual and neurological episodes, often migraine auras, are common in older adults. Late onset migraine accompaniment is typically benign but warrants investigation for serious conditions.

Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Transient visual and neurological episodes are common, particularly in middle and older age.
  • Migraine auras are a frequent cause of these episodes, characterized by stereotypical neurological or visual disturbances.
  • Diagnosis relies on International Headache Society criteria, with suspected neurovascular mechanisms underlying pathophysiology.

Observation:

  • Auras are transient, typically lasting 4 to 60 minutes.
  • Migraine may present with or without headache, accompanied by systemic and autonomic symptoms.
  • Acephalgic migraines occur without headache; late onset migraine accompaniment specifically affects middle-aged and older adults.

Findings:

  • Late onset migraine accompaniment is generally benign.
  • Migraine auras can be mimicked by more serious underlying conditions.

Related Experiment Videos

  • A stable migraine pattern with normal neurological evaluation usually requires no further testing.

    • Implications:

    • Patients with atypical presentations, older age, or suspected secondary causes require thorough investigation.
    • Understanding migraine aura helps differentiate benign conditions from potentially severe ones.
    • This knowledge aids in appropriate diagnostic and management strategies for transient neurological events.