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Late-life migraine accompaniments: A narrative review
Kiratikorn Vongvaivanich1, Paweena Lertakyamanee2, Stephen D Silberstein3
1Comprehensive Headache Clinic, Neuroscience Center, Bangkok Hospital, Bangkok Hospital Group, Thailand.
Cephalalgia : an International Journal of Headache
|December 16, 2014
Summary
Late-life migraine accompaniments, transient neurological episodes in older adults, are common and often present without headache. Visual disturbances are most frequent, mimicking other conditions and requiring careful diagnosis.
Area of Science:
- Neurology
- Geriatrics
Background:
- Migraine is a prevalent chronic neurological disorder.
- Late-life migraine accompaniments (LLMA) were first described in 1980 as transient neurological episodes in older individuals mimicking TIAs.
- No recent updates exist on LLMA etiology or nature since the initial description.
Purpose of the Study:
- To comprehensively review LLMA, covering epidemiology, clinical features, differential diagnosis, and treatment.
- To provide an extensive overview of late-life migraine accompaniments.
- To update the understanding of LLMA in clinical practice.
Main Methods:
- Conducted literature searches in major databases (MEDLINE, PubMed, Cochrane, EMBASE) from 1941 to July 2014.
- Utilized specific search terms including "Migraine accompaniments," "Late life migraine," and "Transient neurological episodes."
- Focused on publications relevant to elderly migraine and neurological episodes.
Main Results:
- Late-life onset migraine with aura is not uncommon, particularly in the elderly, and can occur without headache.
- Visual symptoms are the most common presentation, followed by sensory, aphasic, and motor deficits.
- Typical features include gradual evolution, transient neurological deficits over minutes, and serial progression of symptoms.
Conclusions:
- LLMA can mimic serious conditions, necessitating careful diagnosis to exclude secondary causes.
- Visual, sensory, aphasic, and motor symptoms characterize LLMA.
- Current treatment options for LLMA are limited and inconsistent.
