Which clinical history findings are characteristic of acephalalgic migraine?

Updated: Oct 16, 2019
  • Author: Rima M Dafer, MD, MPH, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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About 3–5% of migraineurs experience an aura without headache (acephalalgic migraine). This presentation is more common in older patients who have had a history of migraine with aura during early age. Migraine aura without headaches is suspected in patients with a history of recurrent attacks of unilateral transient monocular blindness, without risk factors for other causes of carotid disease, and with a personal or family history of migraine.

Symptoms may include scintillating scotomata, formed stereotyped visual hallucinations in a single visual field or bilaterally, micropsia, and tunnel vision. [73] Other auras include paroxysmal vertigo, hemisensory dysesthesias, and, rarely, auditory hallucinations. Acephalalgic migraine should be differentiated from transient ischemic attacks, occipital lobe seizures, and temporal lobe seizures.

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