Presentation
Some patients with atypical presentation, older age, or suspected secondary causes need further investigation. [tandfonline.com]
These phenomena were present for 2 weeks to 25 years. [ncbi.nlm.nih.gov]
Presently, no clinical trials have been performed to evaluate treatment options, but case reports suggest that most patients will respond to the traditional treatments for migraine with aura. Shah DR, Dilwali S, Friedman DI. [mdedge.com]
Abstract SYNOPSIS The diagnosis of acephalgic migraine is complicated by the fact that other neurological conditions such as transient ischaemic attacks, demyelinating disease, simple partial epilepsy, and even glaucoma, can present with similar symptoms [headachejournal.onlinelibrary.wiley.com]
No medical history of relevance except migraine and asthma.She presented worried, at a medical appointment, with complaints of clitoral paresthesia episodes with 2 weeks of evolution. [galiciaclinica.info]
Entire Body System
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Epilepsy
Abstract SYNOPSIS The diagnosis of acephalgic migraine is complicated by the fact that other neurological conditions such as transient ischaemic attacks, demyelinating disease, simple partial epilepsy, and even glaucoma, can present with similar symptoms [headachejournal.onlinelibrary.wiley.com]
[…] diagnosis of BCOS from basilar migraine and migraine with aura has been detailed. 2-4 The difficulties in their differentiation are shown by the fact that the first account 5 compatible with what is now established as BCOS 6-8 classified this type of epilepsy [n.neurology.org]
Epilepsy: a comprehensive textbook. 1 (2nd ed.). Lippincott Williams & Wilkins. p. 2695. ISBN 0-7817-5777-0. Miller, Neil R.; Frank Burton Walsh; Valérie Biousse; William Fletcher Hoyt (2005). [en.wikipedia.org]
Occasionally, patients with acephalgic migraine are misdiagnosed as suffering epilepsy with visual seizures, but the reverse misdiagnosis is more common. [findzebra.com]
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Falling
While acephalgic migraine would fall into the category of migraine aura without headache, episodes of migraine aura without headache can occur in individuals with a history of classic migraine. [medical-dictionary.thefreedictionary.com]
Although these descriptive terms are used fairly frequently, they fall short of a diagnosis and may also be used differently from one doctor or patient to another. [migrainedisease.org]
Such terms may be used fairly frequently, but they fall short of a diagnosis and may also be used differently from one doctor to another. [healthcentral.com]
My eye feels like it’s going to fall out, stabbing and throbbing. I also suffer with chronic migraines on top of the ocular ones. [themighty.com]
For example if a drug has a side effect of dizziness, this could be of more concern to a person who may also be at risk of falling, than another younger person for whom the same side effect may not be as serious. [migrainetrust.org]
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Painter
There have also been suggestions that the painter Pablo Picasso may have had migrainous auras. [medlink.com]
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Hypersomnia
Clinicians should also investigate possible sleep dysregulation, such as obstructive sleep apnea, periodic limb movement disorder, insomnia and hypersomnia, since studies suggest migraines may be consequent to, or aggravated by, these disorders. 23-25 [reviewofoptometry.com]
Gastrointestinal
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Nausea
The concurrence of other symptoms such as photophobia and nausea can help in determining the proper diagnosis. [findzebra.com]
It is a relatively uncommon variant of migraine in which the patient may experience aura, nausea, photophobia, hemiparesis, and other migraine symptoms, but does not experience headache. [1] It is generally classified as an event fulfilling the conditions [en.wikipedia.org]
These medications can include NSAIDs, anti-nausea medications, ergotamines, or triptans. The choice of medications is somewhat affected by the age of the patient. [migrainedisease.org]
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Choking
Just like a hose that hasn’t had water run through it and sputters for the first few seconds, a migraine is a choking up that starts in the brainstem and hypothalamus. [migraineprofessional.com]
Eyes
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Scotoma
I noted the onset of my typical hemianopic scintillating scotoma in the paracentral area in my left homonymous field. This scotoma gradually enlarged over a period of five minutes. [jamanetwork.com]
This is what a scintillating scotoma may look like to some people. Scintillating scotoma is one symptom of Acephalgic migraine ;head pain is not. [kids.kiddle.co]
[…] involvement was represented by scintillation, transient hemianopia, bilateral central scotomata, classic amaurosis fugax, diplopia, altitudinal field loss, tunnel vision; temporal crescent involvement, and several patients who developed a transient central scotoma [ncbi.nlm.nih.gov]
The classic scintillating scotoma with fortification spectrum is suggestive of migraine. Residual visual field defects may indicate another underlying process, such as cerebrovascular disease or a vascular malformation. [aao.org]
[…] teichopsia (zig-zag lines akin to castle battlements; see Figure 3) are thought of as being the classic migraine aura, a much wider array of symptoms may occur, including reports of 'small bright dots,' 'coloured spots of light,' along with hemianopia, scotomas [medical-dictionary.thefreedictionary.com]
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Scintillating Scotoma
I noted the onset of my typical hemianopic scintillating scotoma in the paracentral area in my left homonymous field. This scotoma gradually enlarged over a period of five minutes. [jamanetwork.com]
This is what a scintillating scotoma may look like to some people. Scintillating scotoma is one symptom of Acephalgic migraine ;head pain is not. [kids.kiddle.co]
The classic scintillating scotoma with fortification spectrum is suggestive of migraine. Residual visual field defects may indicate another underlying process, such as cerebrovascular disease or a vascular malformation. [aao.org]
Scintillating scotoma is the most common symptom which usually happens concurrently with Expanding Fortification Spectra. Also frequently reported is monocular blindness. [findzebra.com]
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Blurred Vision
vision and distortions such as 'mosaic' fractured vision or a 'heat wave' appearance. [medical-dictionary.thefreedictionary.com]
The symptoms may include double or blurred vision, loss of balance, fainting, and difficulty speaking. Hemiplegic migraine. During a hemiplegic migraine, a person will experience temporary numbness, weakness, or paralysis on one side of the body. [medicalnewstoday.com]
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Central Scotoma
scotoma in one eye with alterations in color perception. [ncbi.nlm.nih.gov]
scotoma The most common symptom of acephalgic migraine found in one study was the classic half moon visual disturbance.( Link ) Here is an awesome video which talks about the confusion about acephalgic or silent migraines. [migraineprofessional.com]
Patients often describe a developing central scotoma that gradually enlarges to produce total unilateral visual loss. [reviewofoptometry.com]
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Hemianopsia
The most common symptoms are vertigo and dizziness, but symptoms may also include diplopia, hemianopsias, ataxia, tinnitus, decreased hearing, nausea, bilateral paresthesias, syncope and loss of consciousness. 19 • Ophthalmoplegic migraine is a rare disorder [reviewofoptometry.com]
Some patients who report monocular visual disturbance have hemianopsia which they are not aware of since they do not do a cover/uncover test. This is a diagnosis of exclusion of other causes of transient monocular blindness. [practicalneurology.com]
Homonymous hemianopsia as the presenting sign of migrainous infarction. Canadian Journal of Ophthalmology. 2018. 6.0 6.1 Kreling GAD, de Almeida NR, dos Santos PJ. Migrainous infarction: a rare and often overlooked diagnosis. [eyewiki.org]
Musculoskeletal
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Fracture
Figure 3) are thought of as being the classic migraine aura, a much wider array of symptoms may occur, including reports of 'small bright dots,' 'coloured spots of light,' along with hemianopia, scotomas, blurred vision and distortions such as 'mosaic' fractured [medical-dictionary.thefreedictionary.com]
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Arthritis
It is a widespread, chron Read More Arthritis - Living & Coping With It MedIndia.net 12th October, celebrated as World Arthritis Day (WAD), is an attempt to promote awareness regarding arthr show more Migraine and Headache - Do's & Dont's Ms.Jyoti Dadlani [practo.com]
Neurologic
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Aura
Description: Migraine with typical aura in which aura is neither accompanied nor followed by headache of any sort. Diagnostic criteria: A. Attacks fulfilling criteria for 1.2.1 Migraine with typical aura and criterion B below B. [ichd-3.org]
Furthermore, typical aura without headache, also known as migraine aura without headache or acephalgic migraine, commonly presents with visual aura without headache, brainstem aura without headache, and can also develop later in life, known as late-onset [mdedge.com]
His depiction of Alice may be a manifestation of the micropsia, macropsia, or metamorphopsia seen in migrainous auras of childhood. There have also been suggestions that the painter Pablo Picasso may have had migrainous auras. [medlink.com]
A visual migraine aura occurring in isolation is called an ' acephalgic migraine .' [medical-dictionary.thefreedictionary.com]
The aura is generally followed by a headache but in some migraine attacks, there is aura without headache, previously called silent migraine, or acephalgic migraine and can become more common as people get older. ALBP, 25 years old, single. [galiciaclinica.info]
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Headache
Cranial Neuralgias and Facial Pain by the Headache Classification Committee of the International Headache Society. [medical-dictionary.thefreedictionary.com]
Migraine aura without headache. Curr Pain Headache Rep. 2018;22:77. doi:10.1007/s11916-018-0725-1. [mdedge.com]
Headache was denied, and the neurologic exam, EEG, VER, and CT were normal. [pediatricneurologybriefs.com]
That’s one reason why most doctors diagnose based in the International Headache Society’s International Classification of Headache Disorders, 3nd Edition (ICHD-III). [migrainedisease.org]
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Seizure
We argue that this child's symptoms would favor benign childhood occipital seizures (BCOS) rather than migraine. [n.neurology.org]
Migraine aura without headache should be diagnosed only when transient ischemic attack and seizure disorders have been ruled out. 2019 Galicia Clínica. Complete article Pdf article [galiciaclinica.info]
If there is any alteration in consciousness, seizure disorders should also be ruled out. [migrainedisease.org]
Occasionally, patients with acephalgic migraine are misdiagnosed as suffering epilepsy with visual seizures, but the reverse misdiagnosis is more common. [findzebra.com]
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Paresthesia
In 1986, a study of 85 cases demonstrated that 21 patients had visual symptoms; 6 had visual symptoms and paresthesias; 2 had visual symptoms and speech disturbances; 3 had visual symptoms, paresthesias and speech disturbances; 20 had visual symptoms, [medlink.com]
No medical history of relevance except migraine and asthma.She presented worried, at a medical appointment, with complaints of clitoral paresthesia episodes with 2 weeks of evolution. [galiciaclinica.info]
Classic migraine : Migraine headache with aura (loss of vision or other visual symptoms, paresthesias, motor dysfunction) precedes the throbbing headache. 15-20% of migraines are classic (Russell and Olesen, 1996). [dizziness-and-balance.com]
Patients often report a speech disturbance when the spreading paresthesias reach the face or tongue. Slurred speech may be present. [practicalneurology.com]
Some patients experience gradually developing, non-visual, sensory and motor auras, including numbness or tingling in the arms and hands, paresthesias of the tongue resulting in slurred speech and, rarely, vertigo and ataxia. [reviewofoptometry.com]
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Macropsia
His depiction of Alice may be a manifestation of the micropsia, macropsia, or metamorphopsia seen in migrainous auras of childhood. There have also been suggestions that the painter Pablo Picasso may have had migrainous auras. [medlink.com]
Occasionally, patients experience visual hallucinations such as macropsia or micropsia. [reviewofoptometry.com]
Less common and rare visual auras include corona phenomena, palinopsia, 20 metamorphopsia, macropsia, micropsia, telescopic vision, teleopsia, mosaic vision, and multiple images. [practicalneurology.com]
Common visual symptoms of Alice in Wonderland Syndrome include pelopsia, telopsia, micropsia, macropsia, and hallucinations. [eyewiki.org]
Workup
Visual Field Test
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Central Scotoma
scotoma in one eye with alterations in color perception. [ncbi.nlm.nih.gov]
scotoma The most common symptom of acephalgic migraine found in one study was the classic half moon visual disturbance.( Link ) Here is an awesome video which talks about the confusion about acephalgic or silent migraines. [migraineprofessional.com]
Patients often describe a developing central scotoma that gradually enlarges to produce total unilateral visual loss. [reviewofoptometry.com]
Treatment
Treatment The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine, but the symptoms are usually less severe than those of classic migraine, so treatment is less likely to be required. [findzebra.com]
Maps Acephalgic migraine Treatment The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine, but the symptoms are usually less severe than those of classic migraine, so treatment is less likely to be required. [wikiclassicinfo.blogspot.com]
[ edit ] The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine, but the symptoms are usually less severe than those of classic migraine, so treatment is less likely to be required. [en.wikipedia.org]
Traci Purath for the acephalgic migraine treatment right for you and put an end to your pain! Contact migraine neurologist, Dr. Traci Purath for acephalgic migraine treatment and put an end to your pain today! [drtracipurath.com]
Acute treatment of migraine with dihydroergotamine nasal spray is reported from the University Headache Center, Moorestown, NJ [ 4 ]. Newer and experimental treatments for migraine are generally inappropriate for use in children. [pediatricneurologybriefs.com]
Prognosis
In this article, the author reviews the clinical manifestations, prevalence, pathophysiology, therapeutic options, and prognosis for this selective group of patients. [medlink.com]
Herein we summarize the clinical features and prognosis of 46 patients (six new cases and 40 from the literature) with retinal migraine based upon the International Classification of Headache Disorders-2 (ICHD-2) criteria. [journals.sagepub.com]
However, symptoms may recur with onset of migraine in chronic cases. [42] Prognosis Relapse has been implicated in chronic migraine. Certain factors have been proposed as predictors of poor prognosis in migraine. [eyewiki.org]
What is the prognosis for a person with migraines? Is there a cure? Most people who have migraines find that their headaches may be controlled with the preventive medications and lifestyle changes. [medicinenet.com]
Etiology
Possible etiologies include migrainous infarction or vasospasm and ischemia. [eyewiki.org]
This review will help you better understand the etiology and pathophysiology of migraine and will walk you through clinical evaluation and management approaches that are integral to helping this patient population. [reviewofoptometry.com]
Neuroimaging is only necessary if another etiology is suspected due to the presence of neurologic abnormalities, an atypical pattern of headache, or progression of symptoms despite appropriate treatment. [nutritionguide.pcrm.org]
Epidemiology
Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep. 2013;17:341. Buse DC, Manack AN, Fanning KM, Serrano D, Reed ML, Turkel CC, Lipton RB. [practicalneurology.com]
Migraine: Epidemiology, Impact, and Risk Factors for Progression. Headache. 2005 Apr; 45 Suppl 1:S3-S13. doi: 10.1111/j.1526-4610.2005.4501001.x. May A, Schulte LH. Chronic migraine: risk factors, mechanisms and treatment. [eyewiki.org]
Pathophysiology
The pathophysiology is believed to involve neurovascular mechanisms. There is a hereditary component to migraine. When migraine auras occur in the absence of headache they are termed acephalgic migraines. [tandfonline.com]
Its pathophysiology is suggested to be similar to classic migraines, with cortical spreading depression leading to aura formation but without an associated headache. [mdedge.com]
In this article, the author reviews the clinical manifestations, prevalence, pathophysiology, therapeutic options, and prognosis for this selective group of patients. [medlink.com]
Other structures involved in migraine pathophysiology include the periaqueductal gray (PAG), locus coeruleus (LC), and dorsal raphe nucleus (DRN). [3] [19] The specific pathophysiology has not been elucidated for all subtypes of migraine. [eyewiki.org]
Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. . Accessed May 9, 2019. Coppola G, et al. Clinical neurophysiology of migraine with aura. The Journal of Headache and Pain. 2019;20:42. Migraine information page. [mayoclinic.org]
Prevention
When Migraines are frequent, the same preventive therapies used for other Migraines can be explored. Related Copyright 2019 Teri Robert. All rights reserved. 2018-04-29 [migrainedisease.org]
Treatment The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine, but the symptoms are usually less severe than those of classic migraine, so treatment is less likely to be required. [findzebra.com]
Maps Acephalgic migraine Treatment The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine, but the symptoms are usually less severe than those of classic migraine, so treatment is less likely to be required. [wikiclassicinfo.blogspot.com]
When migraines are frequent, the same preventive therapies used for other migraines can be explored. Live well, [healthcentral.com]
The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine, but the symptoms are usually less severe than those of classic migraine, so treatment is less likely to be required. [youtube.com]