Asymmetry of the aura and pain in migraine

Patients with classical migraine whose auras included paraesthesiae or numbness in the hands have been reviewed. In 55 of 111 patients the symptoms were on the same side of the body as the headache and in only 20 on the opposite side to the headache. In the remaining 36 patients one or other was incompletely lateralised. Five right handed patients described dysphasia at the same time as paraesthesiae in the their non-dominant hand. These findings are incompatible with the notion that the headache is due to reactive hyperaemia following localised cerebral ischaemia, and it is suggested that the ischaemic and hyperaemic processes are both the result of some more generalised vasomotor disturbance.