It is usually followed by headache but can occur in isolation without reported pain. Aura is often unilateral and dynamic and involves at least one positive visual phenomenon. 1 AURAĪura in migraine consists of recurrent attacks of unilateral, fully reversible visual, sensory, or other central nervous system symptoms that evolve over minutes and last less than an hour (most commonly 10–30 minutes). The headache is accompanied by at least nausea and/or vomiting or by photophobia and/or phonophobia. being aggravated by, or causing avoidance of, routine physical activity (eg, walking or climbing stairs).carrying a moderate or severe pain intensity and.Left untreated, the headache in migraine lasts 4 to 72 hours and is associated with at least two of the following four characteristics: This distinction is important because several meta-analyses of the literature have shown a twofold increase in the risk of ischemic stroke for patients who experience migraine with aura versus those who experience migraine without aura. 2,3 Migraine is classified into migraine with aura (classic migraine) and without aura (common migraine). The Global Burden of Disease Study of 2015 ranked migraine the third-highest cause of disability worldwide in both men and women less than 50 years of age. 1 Migraine is the second most common form of primary headache disorder, behind only tension-type headache. Headaches come in many forms, as described in the International Headache Society guidelines. It is important to distinguish between primary and secondary headache syndromes because both the patient's health and peace of mind are at stake. Primary headache disorders such as migraine with aura produce positive visual phenomena, and secondary headaches such as compressive intracranial lesions cause visual changes due to increased intracranial pressure or mass effect on the intracranial visual pathways. Although it is always important to evaluate these patients for ocular causes of visual disturbances and to treat those causes, if present, ophthalmologists often face patients who are experiencing visual disturbances in the absence of visible ocular pathology. Headache syndromes often involve the visual system, and patients frequently seek eye care for symptoms that may or may not be related to migraine aura.
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