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Summary
Acephalgic migraine, a type of migraine without headache, presents with diverse neurological symptoms, particularly visual disturbances. This condition should be considered in acute episodic neurological disorders.
Area of Science:
- Neurology
- Ophthalmology
Background:
- Acephalgic migraine is a variant of migraine characterized by neurological symptoms without a preceding or accompanying headache.
- Understanding its presentation is crucial for accurate diagnosis and management.
Purpose of the Study:
- To evaluate patients with acephalgic migraine.
- To characterize the range of neurological and ocular symptoms associated with this condition.
- To emphasize the importance of considering migraine in episodic neurological events.
Main Methods:
- Retrospective analysis of 61 patients diagnosed with acephalgic migraine.
- Evaluation of patient demographics, symptom duration, frequency, and type of neurological and ocular involvement.
- Review of family history and occurrence of permanent neurological deficits.
Main Results:
- Patients aged 21-61 experienced spells lasting 15 seconds to 3 hours, over periods of 2 weeks to 25 years.
- Ocular symptoms were common, including visual disturbances like transient hemianopia, scotomata, and diplopia.
- Other neurological involvement occurred in 29% of patients, with only one experiencing a permanent deficit. A positive family history for migraine was noted in only 24%.
Conclusions:
- Headache is not a mandatory feature of migraine.
- Acephalgic migraine presents with a wide spectrum of neurological and ocular symptoms.
- Clinicians should consider migraine in the differential diagnosis of any acute, episodic neurological disorder, even in the absence of headache.