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SYMPTOMS | PATHOMECHANISMS | HISTORY

Symptoms

Transitory aura symptoms

Persistent aura symptoms

Internet survey

German version

Def. pers. aura

Worsening factor...

Improving factor...

VS and spiritual...

Persistent aura and spirituality

VS and arts

Case vignettes

FAQs

Author: Klaus Podoll, Markus Dahlem, Sofia Greene	27. February 2007
Edited by: Klaus Podoll, Markus Dahlem, Sofia Greene

Duration of definite persistent aura

For the group of 60 subjects with a diagnosis of definite persistent aura without infarction, the mean duration of the 1st episode of persistent aura was 9,1 years (with a range from 1 week to 39 years). Broken down by the outcome, the mean duration of the 1st episode of persistent aura was 1,2 months (range 1 week - 3 months) for the 5 episodes with complete remission, 5,6 years (range 1 month - 20 years) for the 10 episodes with partial remission, 11,2 years (range 1 week - 39 years) for the 43 episodes with stable disease and 3,2 years (range 2,3 – 4 years) for the 2 episodes with progressive disease.

Persistent auras that last a couple of weeks and then resolve are probably more common

"I bet persistent auras that last a couple of weeks and then resolve are probably more common than any of the doctors realize. It took 6 months for me to get a diagnosis and I never would have pushed it with the doctors if it all just went away after a couple of weeks. I've had many episodes of a couple of weeks of parasthesias that then went away, vertigo that went away, I spent a whole summer crawling along the cubicles at work -- my vision was probably whacked out in subtle ways that I could not describe. It went away. Too bad it all came back to stay."

(SopuliSusie [subject #405], Yuku forum Visual snow or static - General discussion - Important new publication on persistent aura, October 31, 2007)

In the 36 subjects with a total of 106 further episodes of persistent aura, the mean duration of the further episodes of persistent aura was 2,3 years (with a range from 1 week to 29 years). Broken down by the outcome, the mean duration of the further episodes of persistent aura was 2,1 months (range 1 week - 4 years) for the 35 episodes with complete remission, 2,4 years (range 3 months - 5 years) for the 26 episodes with partial remission, 4,0 years (range 2 weeks - 29 years) for the 42 episodes with stable disease and 2,5 years (range 1,5 years - 4 years) for the 3 episodes with progressive disease.

The maximum duration after which a full remission of the symptoms brought on by an episode of persistent aura was reported was 4 years. Gyps Kindra (subject #120), who has experienced visual snow and tinnitus at nighttime as long as she can remember, described her 2nd episode of persistent aura as follows: "In 1988, at the age of 12, I had the first notice of vs during the day and the first notice of afterimages on bright walls... The afterimages did certainly disappear after 4 years. The vs was always present in the dark, I can't remember seeing it during the day from 1992 to 2002." From a neurorehabilitational point of view, the 4-years-duration after which Gyps Kindra observed a full remission of her 2nd episode of persistent aura is remarkably longer than the 1-2 years period within which a full remission can still be expected to occur in ischemic lesions due to stroke, highlighting an important clinical distinction between the long-lasting symptoms encountered in persistent aura without infarction and in stroke, respectively. Based on this consideration, it cannot be excluded that full recovery may occur even for episodes of the given migraine complication lasting longer than 4 years, but such cases have yet to be documented.

In the 36 subjects with a total of 106 further episodes of persistent aura, the mean onset-to-onset interval of successive episodes was 4,3 years with a range from 1 month to 36 years. As shown in the figure above, the mean onset-to-onset intervals decreased with increasing ordinal numbers of the successive episodes, i.e. in subjects with multiple episodes the successive rounds of persistent symptoms tended to occur after ever shorter intervals.

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Pre-publication research on migraine with aura