What are the signs and symptoms of pediatric migraine with aura?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Answer

An aura is a sudden and self-limited neurologic dysfunction that generally lasts a few minutes; sometimes several can occur simultaneously or sequentially. The following symptoms can develop:

  • Visual symptoms - Scotomas, phosphenes that look like stars, straight or broken lines (fortification spectra), colors, illusions of shape (micropsias, macropsias, dysmorphopsia), and, rarely, hallucinations (more complex pictures)

  • Sensory symptoms - Paresthesias, rarely dysmorphopsia (impression one's body is deformed)

  • Motor symptoms - Paresis or hemiplegia, especially prominent in familial hemiplegic migraine (FHM)

  • Speech or language disturbance - Dysarthria, aphasia

  • Other cognitive effects - Confusion or amnesia

All of these symptoms have been attributed to cortical dysfunction. In a few instances, the aura supposedly has a brain-stem origin, although it has never been proven (eg, loss of consciousness, ophthalmoparesis, vertigo).

In cases of migraine with aura, the above symptoms precede a sharply defined headache. Adolescent and adult patients who have migraine with aura are thought to be at a higher risk for ischemic stroke, with this risk being magnified among women, patients younger than 45 years, smokers, and persons using oral contraceptives. [32]


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