The spectrum of migraine aura: Towards a precise phenotypic classification

Area of Science:

• Neurology
• Clinical Neuroscience

Background:

• Migraine aura presents as transient focal neurological symptoms, including visual, sensory, and dysphasic disturbances.
• The manifestations of migraine aura exhibit significant inter- and intra-individual variability, complicating precise classification.

Purpose of the Study:

• To conduct a narrative review of literature to identify variables contributing to migraine aura classification.
• To propose a systematic method for recording migraine aura features in clinical and research settings.

Main Methods:

• A comprehensive literature review was performed to analyze the spectrum of migraine aura variables.
• A prospective diary model was developed based on the identified aura features for systematic data collection.

Main Results:

• Visual aura symptoms are particularly multifaceted, with numerous described variations in quality, color, intermittence, and spatial characteristics.
• Sensory and dysphasic symptoms are less complex, but symptom combinations and timing relative to headache onset/offset add significant variability.
• Hundreds of potential migraine aura scenarios exist due to the wide range of symptom presentations.

Conclusions:

• Migraine auras display a broad and complex spectrum of symptoms, necessitating detailed recording for accurate phenotypic classification.
• A prospective aura diary is crucial for systematically capturing these variables to advance the precise phenotypic classification of migraine aura.