Vestibular Migraine with Visual Aura and Olfactory Hallucination in Children: Two Case Reports

Background Approximately 3.9% children with migraine have olfactory hallucination which was defined as a perception of a smell without the substantial existence of any physical odor. Case We described the first two cases of children with vestibular migraine, presenting visual aura and olfactory hallucination. We reported two children with vertigo, visual aura, and olfactory hallucination before the headache who were responsive to topiramate. Conclusion The clinical description of olfactory hallucination presented some characteristics of migraine aura. Olfactory hallucinations could be inserted as a migraine aura in International Classification of Headache Disorders.

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Olfactory hallucination in childhood primary headaches: Case series

Cephalalgia ◽

10.1177/0333102414535998 ◽

2014 ◽

Vol 35 (3) ◽

pp. 234-239 ◽

Cited By ~ 5

Author(s):

MAS Ahmed ◽

Sarah Donaldson ◽

Francis Akor ◽

Denise Cahill ◽

Raed Akilani

Keyword(s):

Children And Adolescents ◽

Case Series ◽

Primary Headaches ◽

Migraine Aura ◽

Headache Disorders ◽

Visual Aura ◽

Headache Diagnosis ◽

Neurologically Normal ◽

Olfactory Hallucination

Background Although olfactory hallucination (OH) has been reported in patients with primary headaches, olfactory aura has not been recognised by the International Classification of Headache Disorders (ICHD-2). In this study, we examined the frequency and characteristics of OH among children and adolescents with primary headaches. Methods 839 neurologically normal patients with primary headaches (537 migraine) were eligible for the assessment of olfactory hallucination. Headache diagnosis was based on the ICHD. Data were prospectively collected during clinic sessions and using headache diaries. Results Olfactory hallucination was reported exclusively during headache attacks by 21/839 (2.5%) patients, all of whom had migraine. The prevalence of olfactory hallucination was 3.9% among migraineurs (6.5% among those with migraine aura). Olfactory hallucination shortly followed the onset of headaches and lasted from 15 to 50 minutes. Of those with MA, 10 patients had visual aura; two had somatosensory aura; one had motor aura; and two had a combination of visual and somatosensory aura. Using the ICHD-2, both OH and migraine aura occurred in the same headache attacks. In 12/15 patients, OH occurred simultaneously with migraine aura, whereas in 3/12 patients, it preceded aura. Conclusion Our findings show that olfactory hallucination occurs in migraine and it has similarities to migraine aura.

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Visual Aura in Migraine: An Analysis of 165 Patients in a Tertiary Care Hospital in North India

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0040-1721624 ◽

2021 ◽

Author(s):

Monika Singla ◽

Richa Kale ◽

Jaisal Brar ◽

Sanskriti Bhardwaj ◽

Keyword(s):

Visual Analysis ◽

Descriptive Analysis ◽

Tertiary Care ◽

International Classification ◽

Care Hospital ◽

Headache Disorders ◽

Visual Aura ◽

Number Of Patients ◽

Scintillating Scotoma

Abstract Background Migraine auras are transient neurological symptoms, usually lasting for approximately 5 to 30 minutes before the onset of migraine pain. Out of various types of auras, visual aura is the commonest and has variable manifestations, forming approximately 90% of auras. These visual auras may be of particular interest to the ophthalmologist as well as to the neurologist. We planned to conduct this study to look for the prevalence of visual aura in our population and make a descriptive analysis of the same. Materials and Methods It was an observational, questionnaire-based cross-sectional study, enrolling all the consenting patients of migraine. Migraine was classified by International Classification of Headache Disorders (ICHD)-III β version, Third edition of International Classification of Headache Disorders. Patients in whom aura was present, detailed profile of visual aura was made regarding its type, duration, relation with migraine as per its laterality, etc. Observations and Results Out of 1,245 migraine patients, 165 (13.25%) patients reported to have visual aura, 127 females and 38 males. Scintillating scotoma was the commonest type of visual aura, then zigzag lines, blurred vision, and tunnel vision. Majority of patients had aura between 5 and 35 minutes, none had more than 60 minutes. A total of 142 patients out of 165 had unilateral aura, out of which 64 (38.78%) patients had aura ipsilateral to the side of headache, and 78 (47.27%) patients had aura contralateral to the side of headache. Twenty-three (13.93%) patients had bilateral aura. Discussion The frequency of visual aura was found to be 13.25% in our study, which is high compared with previously published Indian data. We did a descriptive analysis of visual aura symptoms. Conclusion Visual aura is the commonest type of aura, more frequent in females. Scintillating scotoma was found to be the commonest type of visual aura, followed by zigzag lines in study. Our study is unique of its type as its shows a descriptive visual analysis in a larger number of patients.

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Visual symptoms and childhood migraine: Qualitative analysis of duration, location, spread, mobility, colour and pattern

Cephalalgia ◽

10.1177/0333102418766872 ◽

2018 ◽

Vol 38 (14) ◽

pp. 2017-2025

Author(s):

Mas Ahmed ◽

Catriona Boyd ◽

Radhika Vavilikolanu ◽

Bushra Rafique

Keyword(s):

Qualitative Analysis ◽

Children And Adolescents ◽

Visual Fields ◽

International Classification ◽

Headache Disorders ◽

Visual Aura ◽

Visual Symptoms ◽

Research And Innovation ◽

Beta Version

Aim To examine the characteristics of visual symptoms during attacks of migraine in children and adolescents. Method A qualitative analysis of prospectively collected data over 5 years, on characteristics of visual symptoms during migraine attacks. Diagnosis of migraine and aura was based on the International Classification of Headache Disorders 3rd edition beta version. We also provided the opportunity for patients to illustrate their visual aura symptoms to aid in diagnosis. Results Visual symptoms were reported by 387/1079 (36%) of migraineurs. Of these, 172 (16%) patients fulfilled the International Classification of Headache Disorders Criteria A, B, C iv and D, but missed one (n = 75; 43.5%) or two (n = 97; 56.5%) of the remaining items of criteria C as the visual symptoms were of non-gradual spread (n = 35; 20%), appeared in both visual fields (n = 99; 58%), or lasted less than 5 minutes or more than 60 minutes (n = 129; 75%). Conclusion The International Classification of Headache Disorders 3rd edition beta version criteria are useful in diagnosis of migraine with visual aura in children and adolescents, but visual symptoms varied considerably in duration, pattern, mobility, location, mode of onset and colours. Providing opportunity for patients to illustrate their symptoms can provide additional diagnostic information. The pathophysiology and the clinical concept of typical MVA is still to an extent an assumption and needs further evaluation. Approval The study was approved by the Health Research Authority – London and the local Research and Innovation Department at Barking Havering and Redbridge National Health Service Trust. Formal parental consent was not considered essential for this type of study.

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International Classification of Headache Disorders 3rd edition beta-based field testing of vestibular migraine in China: Demographic, clinical characteristics, audiometric findings and diagnosis statues

Cephalalgia ◽

10.1177/0333102415587704 ◽

2015 ◽

Vol 36 (3) ◽

pp. 240-248 ◽

Cited By ~ 21

Author(s):

Yixin Zhang ◽

Qingtao Kong ◽

Jinjin Chen ◽

Lunxi Li ◽

Dayan Wang ◽

...

Keyword(s):

Clinical Characteristics ◽

Cerebral Arteries ◽

Field Testing ◽

International Classification ◽

Vestibular Migraine ◽

Headache Disorders ◽

Headache Clinic ◽

Definition Of ◽

Beta Version

Objectives This study explored the clinical characteristics of vestibular migraine in Chinese subjects and performed a field test of the criteria of the International Classification of Headache Disorders 3rd edition beta version. Methods Consecutive patients with vestibular migraine were surveyed and registered in a headache clinic during the study period. The diagnosis of vestibular migraine was made according to International Classification of Headache Disorders 3rd edition beta version. Assessments included standardized neuro-otology bedside examination, pure-tone audiogram, bithermal caloric testing, neurological imaging, cervical X-ray or magnetic resonance imaging, Doppler ultrasound of cerebral arteries and laboratory tests. Results A total of 67 patients (62 female/five male, 47.8 ± 10.3 years old) were enrolled in this study. The mean ages of migraine and vertigo onset were 32.2 ± 11.5 and 37.9 ± 10.1 years, respectively. The most common migraine subtype was migraine without aura (79%), followed by migraine with aura (12%) and chronic migraine (9%). The duration of vertigo attacks varied from seconds to days and 25% of patients had attacks that lasted less than 5 minutes. Among the patients with short-lasting attacks, 75% of these patients had ≥5 attacks per day within 72 hours. Auditory symptoms were reported in 36% of the patients. Migraine prophylactic treatments were effective in 77% of the patients. Conclusions Our study showed that the clinical features of vestibular migraine in China were similar to those of Western studies. The definition of vertigo episodes and migraine subtypes of vestibular migraine in International Classification of Headache Disorders 3rd edition beta version might be modified further. More than five vertigo attacks per day within 72 hours might be helpful as far as identifying vestibular migraine patients with short-lasting attacks.

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Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders

Cephalalgia ◽

10.1177/0333102415597890 ◽

2015 ◽

Vol 36 (5) ◽

pp. 454-462 ◽

Cited By ~ 34

Author(s):

Soo-Jin Cho ◽

Byung-Kun Kim ◽

Byung-Su Kim ◽

Jae-Moon Kim ◽

Soo-Kyoung Kim ◽

...

Keyword(s):

Headache Disorder ◽

International Classification ◽

Vestibular Migraine ◽

Headache Disorders ◽

The Third ◽

Common Term ◽

Vestibular Symptoms ◽

The Common ◽

Probable Migraine

Background Vestibular migraine (VM), the common term for recurrent vestibular symptoms with migraine features, has been recognized in the appendix criteria of the third beta edition of the International Classification of Headache Disorders (ICHD-3β). We applied the criteria for VM in a prospective, multicenter headache registry study. Methods Nine neurologists enrolled consecutive patients visiting outpatient clinics for headache. The presenting headache disorder and additional VM diagnoses were classified according to the ICHD-3β. The rates of patients diagnosed with VM and probable VM using consensus criteria were assessed. Results A total of 1414 patients were enrolled. Of 631 migraineurs, 65 were classified with VM (10.3%) and 16 with probable VM (2.5%). Accompanying migraine subtypes in VM were migraine without aura (66.2%), chronic migraine (29.2%), and migraine with aura (4.6%). Probable migraine (75%) was common in those with probable VM. The most common vestibular symptom was head motion-induced dizziness with nausea in VM and spontaneous vertigo in probable VM. The clinical characteristics of VM did not differ from those of migraine without VM. Conclusion We diagnosed VM in 10.3% of first-visit migraineurs in neurology clinics using the ICHD-3β. Applying the diagnosis of probable VM can increase the identification of VM.

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Episodic headache with spontaneous hypothermia reveal Shapiro’s syndrome variant with effectiveness of clonidine therapy

The Journal of Headache and Pain ◽

10.1186/s10194-021-01245-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mickael Aubignat ◽

Melissa Tir ◽

Pierre Krystkowiak ◽

Daniela Andriuta

Keyword(s):

Parkinson’S Disease ◽

Rare Disease ◽

Rare Case ◽

Motor Fluctuation ◽

International Classification ◽

Headache Disorders ◽

Case Presentation ◽

Episodic Headache ◽

Triggering Factor

Abstract Background Episodic headache with spontaneous hypothermia constitute an uncommon association and is not well recognized in the International Classification of Headache Disorders (ICHD-3). Spontaneous periodic hypothermia, also called Shapiro’s syndrome, is a rare disease characterized by hypothermia attacks associated or not with hyperhidrosis without any triggering factor. Case presentation We report a rare case of Shapiro’s syndrome variantrevealed by episodes of headache with spontaneous hypothermia witheffectiveness of clonidine therapy in a 76-year-old Parkinson’s disease woman. Conclusions In the literature, apart from Shapiro’s syndrome, headache withhypothermia seem to occur very rarely. In our case,these symptoms may be considered as a very rare non-motor fluctuation ofParkinson’s disease.

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