Symptoms

Delia Malchert, Scintillating scotoma, 2007. © 2007 Delia Malchert

Transitory aura symptoms

Migraine with aura is a recurrent disorder (with remissions as long as 15 years; Reinecke and Silberstein, 2007) manifesting in attacks of reversible focal neurological symptoms that usually develop gradually over 5 - 20 minutes and last for less than 60 minutes (Grossinger 2006; Sacks 1992). Headache with the features of migraine without aura usually follows the aura symptoms. Less commonly, headache lacks migrainous features or is completely absent (a condition called migraine aura without headache, a designation replacing the older terms migraine equivalent or acephalic migraine). Migraine aura without headache should be diagnosed only when transient ischemic attack and seizure disorders have been excluded (Kunkel, 2005).

A phenomenologically oriented descriptive taxonomy of transitory migraine aura symptoms has not only to account for a great variety of visual disturbances, but also for the many types of illusions and hallucinations of non-visual modalities and a large number of neurological symptoms (e.g. numbness, motor weakness, vertigo, ataxia, speech or language disturbances) and neuropsychological phenomena such as the Alice in Wonderland syndrome. A list of the various transient migraine aura symptoms (and illustrations by sufferers' first-hand accounts from the internet) that may be experienced by a migraineur can be found here.

Sofia Greene, Migraine aura, 2005. © 2005 Sofia Greene

Persistent aura symptoms

Persisting migraine aura symptoms are rare but well documented. "Visual snow" or "tv static", tinnitus, visual loss, increased afterimages and other varieties of visual perseveration being the most prominent symptoms, they are often bilateral and may last for weeks, months or years. Both remissions and permanence of symptoms have been described. On the basis of an internet survey initiated by one sufferer, artist Sofia Greene, the clinical features of persistent aura without infarction are described here.

Google search for search term migraine (see here).

Methodological and ethical considerations

Most of the first-hand accounts of migraine aura experiences presented in this section and elsewhere on this website have been collected from the posts to several support groups for migraine sufferers listed here, thereby "transforming" them into something of new utility, quotations incorporated into a comprehensive series of webpages devoted to the study of migraine aura. We consider our quotations from these internet communities are in line with fair use doctrine.

Attempts to contact the authors of the quoted posts to obtain permission to reproduce materials on this site were made in all cases, but not always successfull. Our readers' feedback (see here) provides testimony of the great impact of these materials, presented in an organised way, for the purpose of medical education. Therefore, we considered it as ethically apt to make use of the given quotes (Eysenbach and Till, 2001; Moloney et al., 2003). We wish to express our thanks to all migraineurs (and to the owners of the given websites) who have provided these materials of great scientific value to this project of a migraine aura website.

References

Eysenbach G, Till JE. Ethical issues in qualitative research on internet communities. BMJ 2001; 323: 1103-1105. [PDF]
Grossinger R. Migraine Auras: When the Visual World Fails. North Atlantic Books, Berkeley California 2006.
Kunkel RS. Migraine aura without headache: benign, but a diagnosis of exclusion. Cleve Clin J Med 2005; 72: 529-534.
Moloney MF, Dietrich AS, Strickland O, Myerburg S. Using Internet discussion boards as virtual focus groups. ANS Adv Nurs Sci 2003; 26: 274-286.
Reinecke RD, Silberstein SD. Migrainous visual auras: a life history. Headache 2007; 47: 123-127.
Sacks OW. Migraine. Revised and expanded. University of California Press, Berkeley-Los Angeles-Oxford 1992.

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