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As part of our CONy 2019 highlight series, the second of two Teva-supported debates revealed fascinating insights into the importance of aura as a prodrome of migraine.

The debate hosted by Dr. Dimos Mitsikostas (National & Kapodiistrian University of Athens, Greece), opposed Drs. Isabel Pavão Martins (University of Lisbon, Portugal) and Margarita Sánchez del Río (Clínica Universidad de Navarra, Madrid, Spain), and examined whether migraine with aura (MA) and migraine without aura (MoA) are the same disease. Dr. Mitsikostas opened the session by reminding the audience that 1–2 out of 5 patients with migraine have auras and that this prevalence is identical in both genders.1 He further described that the likely basis of migraine aura symptoms lies in the phenomenon of cortical spreading depression (CSD), a wave of increased electrocortical

References

  1. Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology. 2001;56(6 Suppl 1):S20-8.

  2. Hadjikhani N, Sanchez Del Rio M, Wu O, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA. 2001;98(8):4687-92.

  3. Vincent MB, Hadjikhani N. Migraine aura and related phenomena: beyond scotomata and scintillations. Cephalalgia. 2007;27(12):1368-77.

  4. Mattsson P, Lundberg PO. Characteristics and prevalence of transient visual disturbances indicative of migraine visual aura. Cephalgia. 1999;19(5):479-84.

  5. Pascual J, Caminero AB, Mateos V, et al. Preventing disturbing migraine aura with lamotrigine: an open study. Headache. 2004;44(10):1024-8.

  6. Vgontzas A, Burch R. Episodic migraine with and without aura: key differences and implications for pathophysiology, management, and assessing risks. Curr Pain Headache Rep. 2018;22(12):78. doi: 10.1007/s11916-018-0735-z.