Current Aura Without Headache
Purpose of Review
This review evaluates and explains our current understanding of a rare subtype of migraine, typical aura without headache, also known as migraine aura without headache or acephalgic migraine.
Typical aura without headache is a known entity within the spectrum of migraine. Its pathophysiology is suggested to be similar to classic migraines, with cortical spreading depression leading to aura formation but without an associated headache. 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. Bilateral greater occipital nerve blocks may be helpful in aborting migraine with prolonged aura. Transcranial magnetic stimulation has shown efficacy in aborting attacks of migraine with aura but has not been specifically tested in isolated aura.
Typical aura without headache occurs exclusively in 4% patients with migraine, and may take place at some point in 38% of patients with migraine with aura. Typical aura without headache commonly presents with visual aura without headache, brainstem aura without headache, and can also develop later in life, known as late-onset migraine accompaniment.
KeywordsTypical aura without headache Acephalgic migraine Migraine aura
Compliance with Ethical Standards
Conflict of Interest
Divya Shah and Sonam Dilwali declare no conflict of interest. Deborah Friedman, MD, MPH, has no relevant conflicts of interest to disclose. She has served on advisory boards for Allergan, Alder Biopharmaceuticals, Avanir, Amgen, Biohaven Pharmaceuticals, electroCore, Eli Lilly, Supernus, Teva and Zosano. She speaks on behalf of Allergan, Amgen, Autonomic Technologies, Inc, electroCore, Supernus and Teva and has received research support through UT Southwestern from Autonomic Technologies, Inc, Eli Lilly, Merck and Zosano. She has received compensation for being on the editorial board for Neurology Reviews and as a contributing author to MedLink Neurology.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance
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