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Persistent aura with small occipital cortical infarction: implications for migraine pathophysiology
Sam Thissen1, Peter J Koehler1
1Department of Neurology, Atrium Medical Centre, Heerlen, The Netherlands.
Case Reports in Neurology
|October 10, 2014
Summary
Persistent migraine aura (PMA) with infarction, previously unreported, may support the intracortical disinhibition hypothesis. This case highlights potential links between infarction and hyperexcitability in migraine aura pathophysiology.
Area of Science:
- Neurology
- Neuroscience
Background:
- Migraine with aura pathophysiology involves cortical spreading depression and hypersensitivity, potentially involving inhibitory interneurons.
- Persistent migraine aura (PMA) is defined as aura symptoms lasting over a week without infarction.
Observation:
- A case of persistent aura with an occipital cortical infarction was identified.
- The patient presented with persistent aura symptoms, but imaging revealed an occipital cortical infarction with reduced metabolic activity.
Findings:
- The infarction may have caused an imbalance in hyperexcitable visual cortex networks already affected by migraine aura.
- This case, while not meeting PMA criteria due to infarction, exhibited persistent aura symptoms.
Implications:
- This is the first reported case of persistent aura with occipital infarction.
- Findings may support the intracortical disinhibition hypothesis in migraine, suggesting infarction could exacerbate aura-related network imbalances.
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