Migraine Without Aura and Migraine with Aura Are Distinct Clinical Entities: A Study of Four Hundred and Eighty-Four Male and Female Migraineurs From the General Population

Cephalalgia ◽  
1996 ◽  
Vol 16 (4) ◽  
pp. 239-245 ◽  
Author(s):  
MB Russell ◽  
BK Rasmussen ◽  
K Fenger ◽  
J Olesen
Keyword(s):  
General Population ◽  
Migraine With Aura ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Age At Onset ◽  
Age Groups ◽  
Bright Light ◽  
Expected Number ◽  
Normal Distributions ◽  
Precipitating Factor

The clinical characteristics of migraine without aura (MO) and migraine with aura (MA) were compared in 484 migraineurs from the general population. We used the criteria of the International Headache Society. The lifetime prevalence of MO was 14.7% with a M:F ratio of 1:2.2; that of MA was 7.9% with a M:F ratio of 1:1.5. The female preponderance was significant in both MO and MA. The female preponderance was present in all age groups in MA, but was first apparent after menarche in MO, suggesting that female hormones are an initiating factor in MO, but not likely so in MA. The age at onset of MO followed a normal distribution, whereas the age at onset of MA was bimodally distributed, which could be explained by a composition of two normal distributions. The estimated separation between the two groups of MA was at age 26 years among the females and age 31 years among the males. The observed number of persons with co-occurrence of MO and MA was not significantly different from the expected number. The specificity and importance of premonitory symptoms are questioned, but prospective studies are needed. Bright light was a precipitating factor in MA, but not in MO. Menstruation was a precipitating factor in MO, but not likely in MA. Both MO and MA improved during pregnancy. The clinical differences indicate that MO and MA are distinct entities.

Migraine With Aura and Migraine Without Aura: An Epidemiological Study

Cephalalgia ◽  
1992 ◽  
Vol 12 (4) ◽  
pp. 221-228 ◽  
Author(s):  
Birthe Krogh Rasmussen ◽  
Jes Olesen
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Age Distribution ◽  
Cross Sectional Study ◽  
Lifetime Prevalence ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Visual Disturbances ◽  
Precipitating Factor

In a cross-sectional study of headache disorders in a representative general population of 1,000 persons the epidemiology of migraine with aura (MA) and migraine without aura (MO) was analysed in relation to sex and age distribution, symptomatology and precipitants. The headache disorders were classified on the basis of a clinical interview as well as a physical and a neurological examination using the operational diagnostic criteria of the International Headache Society (IHS). Lifetime prevalence of MA was 5%, male:female ratio 1:2. Lifetime prevalence of MO was 8%, M:F ratio 1:7. Women, but not men, were significantly more likely to have MO than MA. Neither MA nor MO showed correlation to age in the studied age interval (25–64 years). Premonitory symptoms occurred in 16% of subjects with MA and in 12% with MO. One or more precipitating factor was present in 61% with MA and in 90% with MO. In both MA and MO the most conspicuous precipitating factor was stress and mental tension. Visual disturbances were the most common aura phenomenon occurring in 90% of subjects with MA. Aura symptoms of sensory, motor or speech disturbances rarely occurred without coexisting visual disturbances. The pain phase of MA fulfilled the criteria for MO of the IHS. Headache was, however, less severe and shorter lasting in MA than in MO. Onset at menarche, menstrual precipitation, menstrual problems, influence of pregnancy and use of oral contraceptives all showed some relationship with the presence of MO and less with MA. The present findings suggest that MA and MO share the pain phase. Among subjects with MA and MO, 50% and 62%, respectively, had consulted their general practitioner because of migraine. Selection bias in previous clinical studies is demonstrated by comparisons with the present unselected sample.

Clinical Characteristics of Migraine in A Population-Based Twin Sample: Similarities and Differences Between Migraine with and Without Aura

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 151-158 ◽  
Author(s):  
M Kallela ◽  
M Wessman ◽  
M Färkkilä ◽  
A Palotie ◽  
M Koskenvuo ◽  
...  
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Clinical Characteristics ◽  
Telephone Interview ◽  
International Headache Society ◽  
Epidemiological Data ◽  
Population Based ◽  
Unilateral Headache ◽  
Chi Squared ◽  
Similarities And Differences

Objective: To look into clinical differences between migraine with and without aura in a population-based sample of migraineurs. Background: Migraine presents in two major forms, migraine with and migraine without aura. With the exception of the aura phase, the clinical characteristics of these entities are very similar. Despite this, however, the recent epidemiological data underline differences between migraine with and without aura. We tried to examine whether other features besides the aura differ between these two major forms of migraine. Methods: We studied 321 twins suffering from migraine with aura and 166 twins with migraine without aura from the population-based Finnish Twin Cohort. Migraine was diagnosed according to the criteria of the International Headache Society (MS). Analysis was based on the combination of a mailed questionnaire and a telephone interview by a neurologist. Special attention was paid to differences between migraine with and without aura. Results: Some qualities of headaches differed between IHS defined migraine with and without aura. Unilateral headache (Chi-squared p=0.039) and photophobia (Chi-squared p=0.010) were more typical for migraine with aura, while nausea was more typical for migraine without aura (Chi-squared p=0.002). Duration of headache in migraine without aura was also longer man in migraine with aura (Mann-Whitney U-test 0.007). Conclusions: There are clinical differences between IHS defined migraine with and without aura; even the headache phase between the two entities differs. It is worthwhile distinguishing between them when looking for the elusive genes for these more common forms of migraine.

Migrainous Disorder and its Relation to Migraine Without Aura and Migraine with Aura. A Genetic Epidemiological Study

Cephalalgia ◽  
1996 ◽  
Vol 16 (6) ◽  
pp. 431-435 ◽  
Author(s):  
MB Russell ◽  
J Olesen
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Large Population ◽  
Population Based ◽  
Population Based Study ◽  
Female Ratio ◽  
First Degree Relatives ◽  
Increased Risk ◽  
Male Female Ratio

Migrainous disorder was analysed in a large population-based study of 4000 forty-year-old males and females. All interviews were conducted by one physician and the diagnostic criteria of the International Headache Society were used. Of the 48 people with migrainous disorder, 40 had migrainous disorder without aura and 9 had migrainous disorder with aura One person had co-occurrence of migrainous disorder with and without aura. The lifetime prevalence of migrainous disorder was 2.5% with a male: female ratio of 1:1.2. The first-degree relatives of probands with migrainous disorder were blindly interviewed. Compared with the general population, first-degree relatives of probands with migrainous disorder without aura had a slightly but less increased risk of migraine without aura than first-degree relatives of probands with migraine without aura. First-degree relatives of probands with migrainous disorder with aura had no increased risk of migraine with aura. We conclude that migrainous disorder without aura in some people is a type of migraine without aura and in other people not. Migrainous disorder with aura may be unrelated to migraine with aura. œ

scholarly journals Migraine With Aura and Migraine Without Aura Are Not Distinct Entities: Further Evidence From a Large Dutch Population Study

2006 ◽  
Vol 9 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Lannie Ligthart ◽  
Dorret I. Boomsma ◽  
Nicholas G. Martin ◽  
Janine H. Stubbe ◽  
Dale R. Nyholt
Keyword(s):  
Latent Class Analysis ◽  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Latent Class ◽  
International Headache Society ◽  
Neurological Symptoms ◽  
Class Analysis ◽  
Class 1 ◽  
Screening Question ◽  
Severe Type

AbstractIt is often debated whether migraine with aura (MA) and migraine without aura (MO) are etiologically distinct disorders. A previous study using latent class analysis (LCA) in Australian twins showed no evidence for separate subtypes of MO and MA. The aim of the present study was to replicate these results in a population of Dutch twins and their parents, siblings and partners (N = 10,144). Latent class analysis of International Headache Society (IHS)-based migraine symptoms resulted in the identification of 4 classes: a class of unaffected subjects (class 0), a mild form of nonmigrainous headache (class 1), a moderately severe type of migraine (class 2), typically without neurological symptoms or aura (8% reporting aura symptoms), and a severe type of migraine (class 3), typically with neurological symptoms, and aura symptoms in approximately half of the cases. Given the overlap of neurological symptoms and nonmutual exclusivity of aura symptoms, these results do not support the MO and MA subtypes as being etiologically distinct. The heritability in female twins of migraine based on LCA classification was estimated at .50 (95% confidence intervals [CI] .27 – .59), similar to IHS-based migraine diagnosis (h2 = .49, 95% CI .19–.57). However, using a dichotomous classification (affected–unaffected) decreased heritability for the IHS-based classification (h2 = .33, 95% CI .00–.60), but not the LCA-based classification (h2 = .51, 95% CI .23–.61). Importantly, use of the LCA-based classification increased the number of subjects classified as affected. The heritability of the screening question was similar to more detailed LCA and IHS classifications, suggesting that the screening procedure is an important determining factor in genetic studies of migraine.

Validation of diagnostic criteria for migraine in the Zürich longitudinal cohort study

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 47-53 ◽  
Author(s):  
Kathleen Ries Merikangas ◽  
Amy E Whitaker ◽  
Jules Angst
Keyword(s):  
Young Adults ◽  
General Population ◽  
Diagnostic Criteria ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Gastrointestinal Symptoms ◽  
Tension Type Headache ◽  
Peak Period ◽  
Systematic Assessment ◽  
Ihs Criteria

This paper reports the results of a systematic assessment of the validity of the specific diagnostic criteria for migraine without aura, as defined by the International Headache Society (IHS), in a longitudinal epidemiologic sample of young adults who were selected from the general population of Zürich, Switzerland. Systematic modification of each of the IHS criteria for migraine without aura yielded one-year weighted prevalence rates ranging from 24% for the unmodified IHS criteria to 9% for the most restrictive definition of migraine. The major implications of the findings for the IHS criteria are: (a) they provide adequate coverage to classify the majority of subjects with headache in the general population; (b) there is little overlap between migraine and tension-type headache, suggesting that the criteria define moderately independent subgroups; (c) the criteria for migraine without aura appear to be too unrestrictive for application in the community, particularly among young adults at the peak period of incidence of migraine; (d) the criteria for “aura” need more precise operationalization; and (e) models of validation of the diagnostic criteria suggest that Criterion D of the IHS criteria for migraine without aura should be modified to require both gastrointestinal symptoms and photophobia and phonophobia.

Depression, Migraine With Aura and Migraine Without Aura: Their Familiality and Interrelatedness

Cephalalgia ◽  
2009 ◽  
Vol 29 (8) ◽  
pp. 848-854 ◽  
Author(s):  
HA Ball ◽  
Z Samaan ◽  
S Brewster ◽  
N Craddock ◽  
M Gill ◽  
...  
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Model Fit ◽  
Large Sample ◽  
Sibling Pairs ◽  
Multiple Threshold ◽  
Probable Migraine ◽  
The Relationship ◽  
Underlying Dimension

Migraine is frequently comorbid with depression. There appear to be common aetiological factors for both disorders, but the aetiology of migraine within depressed patients, in particular the significance of aura, has been little studied. A large sample of concordantly depressed sibling pairs [the Depression-Network (DeNT) sample] was assessed as having migraine with aura (MA), migraine without aura (MoA), probable migraine or no migraine according to International Headache Society guidelines. Correlations between siblings' migraine status were used to assess the nature of familial liability to migraine. A multiple threshold isocorrelational model fit best, in which different syndromes are conceptualized as different severities of one underlying dimension rather than as having separate aetiologies. Thus, MA and MoA were found to be different forms of the same disorder, with MA occupying the more extreme end of the spectrum of liability. Implications for our understanding of the relationship between migraine and depression are discussed.

Scent of aura? Clinical features of olfactory hallucinations during a migraine attack (OHM)

Cephalalgia ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Federico Mainardi ◽  
Alan Rapoport ◽  
Giorgio Zanchin ◽  
Ferdinando Maggioni
Keyword(s):  
Migraine Attack ◽  
Clinical Features ◽  
Migraine With Aura ◽  
Temporal Pattern ◽  
Migraine Without Aura ◽  
Age At Onset ◽  
Average Frequency ◽  
Migraine Aura ◽  
Phase 2 ◽  
Olfactory Hallucination

Introduction Olfactory hallucination during a migraine attack (OHM) is a rare phenomenon. At present, it is not considered a manifestation of migraine aura. Material and methods The clinical features of OHM were collected in 11 patients. Results Of the 11 patients, 10 had migraine without aura and one migraine with aura associated with OHM. Mean age at onset of headache and at appearance of OHM were respectively 17.8 and 32.3 years. Migraine average frequency was 3.9 attacks/month, 19% of them being associated with OHM. The temporal pattern of OHM maintained the same characteristics in the different attacks. OHM onset was described as sudden ( n = 5), gradual ( n = 3), initially sudden and then gradual ( n = 2), or developing in a few seconds ( n = 1). In most of the cases ( n = 8) OHM lasted from 3 to 10 minutes; it persisted during the pain phase (2–24 hours) in only three patients. The type of the perceived smell was invariably constant in nine patients. Conclusion OHM features fulfilled the ICHD-III beta criteria for typical aura.

Clinical Characteristics of 362 Patients with Familial Migraine with Aura

Cephalalgia ◽  
2004 ◽  
Vol 24 (7) ◽  
pp. 564-575 ◽  
Author(s):  
MK Eriksen ◽  
LL Thomsen ◽  
I Andersen ◽  
F Nazim ◽  
J Olesen
Keyword(s):  
Migraine With Aura ◽  
Clinical Characteristics ◽  
Familial Aggregation ◽  
International Headache Society ◽  
Age At Onset ◽  
Population Based ◽  
Hemiplegic Migraine ◽  
Visual Aura ◽  
Danish Patient ◽  
Male Patients

The objectives of the present study were to describe the clinical characteristics of patients with severe familial non-hemiplegic migraine with aura (NHMA) and to compare these data to those from cases in previous population-based Danish studies using the same methodology. NHMA families were recruited from the Danish patient registry and from Danish neurology practices. A total of 362 NHMA patients were diagnosed according to the 1988 International Headache Society criteria using a validated semistructured physician-conducted interview. Visual aura occurred in almost every NHMA attack. In aura without headache visual aura occurred primarily in isolation. Aura without headache was most common in older, male patients. Several clinical characteristics of familial NHMA differed from migraine with aura in the general population: firstly, the age at onset was lower, secondly, the age at cessation was higher, thirdly, aura symptoms were more severe and finally, the co-occurrence of migraine without aura was higher in familial NHMA. There seems to be a correlation between more severe symptoms and familial aggregation. These results have both clinical and scientific implications.

Sporadic Hemiplegic Migraine is an Aetiologically Heterogeneous Disorder

Cephalalgia ◽  
2003 ◽  
Vol 23 (9) ◽  
pp. 921-928 ◽  
Author(s):  
LL Thomsen ◽  
E Ostergaard ◽  
SF Romer ◽  
I Andersen ◽  
MK Eriksen ◽  
...  
Keyword(s):  
Relative Risk ◽  
General Population ◽  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Familial Aggregation ◽  
Familial Hemiplegic Migraine ◽  
Danish Population ◽  
Hemiplegic Migraine ◽  
First Degree Relatives ◽  
Increased Risk

In order to better understand sporadic hemiplegic migraine (SHM) and particularly its relation to familial hemiplegic migraine (FHM), migraine without aura (MO) and typical migraine with aura (typical MA), we investigated the occurrence of MO and typical MA among probands with SHM and their first-degree relatives. The pattern of familial aggregation of MO and typical MA was assessed by population relative risk calculations. A total of 105 SHM probands and 483 first-degree relatives were identified in the Danish population. Compared with the general population, SHM probands had no increased risk of MO, but a highly increased risk of typical MA. First-degree relatives of all SHM probands had an increased risk of both MO and typical MA, whereas first-degree relatives of probands with exclusively SHM had no increased risk of MO but an increased risk of typical MA. Our data suggest that SHM is a genetically heterogeneous disorder.

Migraine Headaches in Adolescents: A Student Population-Based Study in Monreale

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 5-12 ◽  
Author(s):  
V Raieli ◽  
D Raimondo ◽  
R Cammalleri ◽  
R Camarda
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Epidemiological Survey ◽  
Population Based ◽  
Student Population ◽  
Population Based Study ◽  
Migraine Headaches ◽  
Ihs Classification ◽  
Juvenile Population

We assessed the prevalence of migraine headaches in an epidemiological survey of an 11 to 14-year-old student population. Migraine headaches were classified on the basis of questionnaires and neurological examination using the operational diagnostic criteria of the International Headache Society. Prevalence of migraine without aura (IHS code 1.1) was 2.35%; that of migraine with aura (IHS code 1.2) was 0.62%. Migraine without aura was equally distributed among males and females, whereas migraine with aura was preponderant in the female cohort. The prevalence of migraine headaches in males was constant through the ages studied, whereas the prevalence of migraine headaches in females reached a peak at age 12 and plateaued over the following two years. Although the new IHS classification criteria of migraines are reliable and exhaustive, some subcriteria may not be valid in a juvenile population. For instance, the duration of the pain in young migraineurs is often briefer than in adults, and the intensity of pain was almost always described as moderate or severe. Therefore, in order to increase the reliability and comprehensiveness of the IHS classification, minor modifications should be made.

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