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.

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.

Trigger factors for familial hemiplegic migraine

Cephalalgia ◽  
2011 ◽  
Vol 31 (12) ◽  
pp. 1274-1281 ◽  
Author(s):  
Jakob Møller Hansen ◽  
Anne Werner Hauge ◽  
Messoud Ashina ◽  
Jes Olesen
Keyword(s):  
Migraine With Aura ◽  
Response Rate ◽  
Bright Light ◽  
Familial Hemiplegic Migraine ◽  
Population Based ◽  
Trigger Factor ◽  
Trigger Factors ◽  
Hemiplegic Migraine

Objective: The aim was to identify and describe migraine trigger factors in patients with familial hemiplegic migraine (FHM) from a population-based sample. Methods: 127 FHM patients were sent a questionnaire listing 16 trigger factors. Distinction was made between attacks of hemiplegic migraine (HM) and migraine with aura (MA) or without aura (MO) within each patient. Results: The response rate was 59% (75/127) of whom 57 (76%) had current HM attacks. Sixty-three per cent (47/75) reported at least one factor triggering HM, and 36% (27/75) reported at least one factor that often or always caused HM. Twenty per cent (15/75) reported only HM, whereas FHM in combinations with MA and MO were reported by 80% (60/75). Stress (with attacks either following or during the stress), bright light, intense emotional influences and sleeping too much or too little were the trigger factors mentioned by most. Conclusion: Many FHM patients report trigger factors and one-third reported at least one trigger factor often or always triggering FHM. The typical triggers are the same as for MA. Patients should be educated to avoid these factors. The role of trigger factors in the onset of new or first attacks of FHM remains unknown.

Side-Shifting Hemicrania Continua with Aura (Migraine with Aura with Autonomic Symptoms Responsive to Indomethacin?)

Cephalalgia ◽  
2006 ◽  
Vol 26 (8) ◽  
pp. 917-919 ◽  
Author(s):  
MFP Peres ◽  
MR Masruha ◽  
WB Young
Keyword(s):  
Chronic Migraine ◽  
Migraine With Aura ◽  
International Headache Society ◽  
Hemicrania Continua ◽  
Visual Aura ◽  
Autonomic Symptom ◽  
Autonomic Symptoms ◽  
Atypical Features ◽  
Ihs Classification ◽  
Complex Cases

Atypical features of hemicrania continua (HC), including both visual aura and side shifting, have been reported previously. However, auras and variable unilaterality have never been reported together in HC. We report two patients with side-shifting HC with aura. These patients' symptoms are unilateral headaches, visual aura, autonomic features, throbbing pain, nausea and photo/phonophobia. One could speculate that the unilaterality and/or the autonomic symptom modules are indomethacin responsive. The patients can also be classified as chronic migraine with aura, with autonomic symptoms, responsive to indomethacin. Neither migraine subtype nor side-shifting HC with aura is included in the current International Headache Society (IHS) classification, so these patients are not classifiable. Side-shifting HC with aura implies the need to revisit the traditional IHS categorization of headaches into unique diagnostic groups. The modular headache theory may be a tool for the understanding of these rare and complex cases.

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.

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

The Clinical Characteristics of Major Depression as Indices of the Familial Risk to Illness

1994 ◽  
Vol 165 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Kenneth S. Kendler ◽  
Michael C. Neale ◽  
Ronald C. Kessler ◽  
Andrew C. Heath ◽  
Lindon J. Eaves
Keyword(s):  
Major Depression ◽  
Clinical Characteristics ◽  
Age At Onset ◽  
Familial Risk ◽  
Population Based ◽  
Treatment Seeking ◽  
Generalised Anxiety Disorder ◽  
Increased Risk ◽  
Co Morbidity ◽  
Familial Vulnerability

BackgroundFrom both a clinical and an aetiological perspective, major depression (MD) is probably a heterogeneous condition. We attempt to relate these two domains.MethodWe examined which of an extensive series of clinical characteristics in 646 female twins from a population-based register with a lifetime diagnosis of MD predicts the risk for MD in co-twins. MD was defined by DSM–III–R criteria.ResultsFour variables uniquely predicted an increased risk for MD in the co-twin: number of episodes, degree of impairment and co-morbidity with panic disorder or bulimia. One variable uniquely predicted decreased risk: co-morbidity with phobia. Variables that did not uniquely predict risk of MD in the co-twin included age at onset, number and kind of depressive symptoms, treatment seeking, duration of the longest episode and co-morbidity with generalised anxiety disorder and alcohol dependence.ConclusionsOur results suggest that the clinical features of MD can be meaningfully related to the familial vulnerability to illness, particularly with respect to recurrence, impairment and patterns of co-morbidity.

The Genetics of Migraine Without Aura and Migraine With Aura

Cephalalgia ◽  
1993 ◽  
Vol 13 (4) ◽  
pp. 245-248 ◽  
Author(s):  
Michael Bjørn Russell ◽  
Jes Olesen
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Familial Aggregation ◽  
Familial Hemiplegic Migraine ◽  
Hemiplegic Migraine ◽  
Future Studies ◽  
Progressive Ataxia ◽  
Reduced Penetrance ◽  
Genetically Determined ◽  
Selection Of

Studies of twins, spouses and familial aggregation strongly suggest that migraine without aura (MO) and migraine with aura (MA) are genetically determined. The mode of inheritance is most likely multifactorial in both MO and MA. However, autosomal dominant inheritance with reduced penetrance cannot be excluded in either MO or MA. At present the only evidence for genetic heterogeneity of MA is familial hemiplegic migraine with slowly progressive ataxia. This phenomenon can also be explained by linkage of different genes. All existing studies have been characterized by one or more of the following methodologic shortcomings: selection of probands from clinic populations, information obtained by questionnaire, family history obtained through probands, insufficient description of the attacks, lack of distinction between MO and MA. Useful strategies for future studies of migraine genetics are discussed.

Familial Hemiplegic Migraine: A Clinical Comparison of Families Linked and Unlinked to Chromosome 19

Cephalalgia ◽  
1996 ◽  
Vol 16 (3) ◽  
pp. 153-155 ◽  
Author(s):  
GM Terwindt ◽  
RA Ophoff ◽  
J Haan ◽  
RR Frants ◽  
MD Ferrari ◽  
...  
Keyword(s):  
Cerebellar Ataxia ◽  
Clinical Features ◽  
Head Trauma ◽  
Clinical Characteristics ◽  
Age At Onset ◽  
Familial Hemiplegic Migraine ◽  
Chromosome 19 ◽  
Hemiplegic Migraine ◽  
Clinical Comparison ◽  
Progressive Cerebellar Ataxia

We compared the clinical characteristics of 50 patients from three unrelated families with familial hemiplegic migraine (FHM) linked to chromosome 19, with those of 20 patients from two families with FHM not linked to chromosome 19. We found no significant differences for age at onset, frequency and duration of attacks, duration of the paresis, and occurrence of basilar migraine symptoms. In the linked families, significantly more patients reported unconsciousness during attacks (39%, vs 15%; p<0.05) and provocation of attacks by mild head trauma (70% vs 40%; p< 0.05). In one linked family patients also displayed chronic progressive cerebellar ataxia, whereas in one unlinked family benign infantile convulsions occurred in addition to FHM. Interestingly, so far an association with cerebellar ataxia was only described in chromosome 19-linked families. FHM linked to chromosome 19 and FHM unlinked to chromosome 19 do not differ with respect to clinical features.

The typical duration of migraine aura: A systematic review

Cephalalgia ◽  
2013 ◽  
Vol 33 (7) ◽  
pp. 483-490 ◽  
Author(s):  
Michele Viana ◽  
Till Sprenger ◽  
Michaela Andelova ◽  
Peter J Goadsby
Keyword(s):  
Literature Search ◽  
Significant Proportion ◽  
Case Series ◽  
Population Based ◽  
Scientific Data ◽  
Migraine Aura ◽  
Hemiplegic Migraine ◽  
Visual Aura ◽  
Prolonged Duration ◽  
Probable Migraine

Background According to ICHD-II, and as proposed for ICHD-III, non-hemiplegic migraine aura (NHMA) symptoms last between five and 60 minutes whereas hemiplegic migraine aura can be longer. In ICHD-III it is proposed to label aura longer than an hour and less than a week as probable migraine with aura. We tested whether this was appropriate based on the available literature. Methods We performed a systematic literature search identifying articles pertaining to a typical or prolonged duration of NHMA. We also performed a comprehensive literature search in order to identify all population-based studies or case series in which clinical features of NHMA, including but not restricted to aura duration, were reported, in order to gain a complete coverage of the available scientific data on aura duration. Results We did not find any article exclusively focusing on the prevalence of a prolonged aura or more generally on typical NHMA duration. We found 10 articles that investigated NHMA features, including the aura duration. Five articles recorded the proportion of patients in whom whole NHMA lasted for more than one hour, which was the case in 12%–37% of patients. Six articles reported some information on the duration of single NHMA symptoms: visual aura disturbances lasting for more than one hour occurred in 6%–10% of patients, sensory aura in 14%–27% of patients and aphasic aura in 17%–60% of patients. Conclusions The data indicate the duration of NHMA may be longer than one hour in a significant proportion of migraineurs. This seems to be especially true for non-visual aura symptoms. The term probable seems inappropriate in ICHD-III so we propose reinstating the category of prolonged aura for patients with symptoms longer than an hour and less than one week.

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.

Sign in / Sign up

Export Citation Format

Share Document