Multisensory hallucinations and other unusual sensory experiences in the context of migraine: a systematic review

Visual auras in migraine have been extensively studied, but less is known about multisensory hallucinations or other unusual sensory experiences, including whether these should be diagnostically considered as part of aura symptoms. The current study aimed to conduct a systematic review and synthesis to bring together existing empirical evidence on these non-visual perceptual experiences, focusing on their phenomenological descriptions and clinical correlates.

Forty-eight relevant studies were included based on a systematic search across PsycINFO APA and Web of Science, for peer-reviewed publications in the English language, from 1980 to the present. These comprised a mix of case reports/series (n = 19) and group design studies (n = 29).

Reports of complex multisensory hallucinations, beyond typical established aura symptoms, were numerous and varied in nature. Yet there were limited data on how this related to patient distress and functional interference. Other sensory distortions or hypersensitivities across non-visual domains were also evident, and generally more common in those with established aura symptoms.

Our findings provide preliminary evidence that multisensory hallucinations and other unusual perceptual experiences in migraine are likely more common than previously believed. Further investigations are needed to appropriately account for these symptoms within current nosological systems. Increased clinician-patient awareness is important for managing distress (where necessary), and potentially for offering a holistic therapeutic approach to migraine management.