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Migraine aura: new ideas about cause, classification, and clinical significance

Charles, Andrew; Hansen, Jakob Møller

Current Opinion in Neurology: June 2015 - Volume 28 - Issue 3 - p 255–260
doi: 10.1097/WCO.0000000000000193
HEADACHE: Edited by Peter J. Goadsby
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Purpose of review The migraine aura is a dramatic spontaneous change in brain activity resulting in a variety of transient neurological symptoms. The purpose of this review is to address recent advances in the understanding of aura and its role in migraine.

Recent findings The formal classification of migraine aura is becoming both broader and more detailed. Traditionally viewed as a primary event that triggers a migraine attack, studies regarding the timing of aura relative to other symptoms of migraine indicate that it may not in fact play a primary role in initiating an attack. Careful recording and analysis of visual aura symptoms provides new insight into the initiation and propagation of the underlying brain phenomenon, and the different regions of visual cortex that produce different visual perceptions. Migraine with aura may have different responses to acute and preventive therapies.

Summary There has been significant evolution of concepts regarding the causes of migraine aura, how it is best defined, and how it fits into the picture of the migraine disorder as a whole. Regardless of its exact role in the genesis of migraine, an increased understanding of aura has the potential to provide important new insight into not only migraine but also fundamental mechanisms of brain physiology.

aHeadache Research and Treatment Program, Department of Neurology, University of California Los Angeles, California, USA

bDanish Headache Centre and Department of Neurology, Glostrup Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Correspondence to Andrew Charles, UCLA Headache Research and Treatment Program, 635 Charles Young Drive, Los Angeles, CA 90095, USA. Tel: +1 310 794 1870; fax: +1 310 206 6906; e-mail: acharles@ucla.edu

Copyright © 2015 Wolters Kluwer Health, Inc. All rights resereved.