L’migraine with aura if you present with the vision of bright butterflies that flutter before the eyes, then become brilliant zig zag lines. And those who suffer from it know that, at this point, the time has come to find a comfortable seat and not to move, not try to talk and do absolutely nothing.
The trouble is if the attack is unleashed while you are at work, or if you are driving a car. Indeed, the next step can be characterized by disturbances that can be frightening. Sometimes it happens that it is no longer possible to speak, you have one word in mind but another completely different one comes out of your mouth. Other patients complain of a strange one tingling in the arm or face. Still others, however, are confused. These are all very disturbing conditions, neurological symptoms that precede the outbreak of the headache and that subside until finally disappearing when, finally, the pain takes over. This form of migraine is not particularly common, but it is very disabling.
Symptoms of migraine with aura
“While migraine without aura affects 11% of the population, migraine with aura is a little more rare and has an incidence of about 8%,” he explains. Licia Thank you, neurologist, head of the headache center of the Irccs Foundation Carlo Besta neurological institute in Milan. “It’s about a form of primary headache described in the classification of headaches of the International Headache Society (IHS), which is characterized by not having only pain as a symptom: it is preceded or accompanied by neurological symptoms, visual disturbances, speech disturbances, tingling in the arm or face and a sense of mental confusion, symptoms that can suggest other more serious neurological diseases such as a stroke or a form of epilepsy. According to some studies, there is a genetic predisposition to migraine with aura that often occurs in the same family unit ».
It is a disabling disorder but attacks are usually sporadic
Migraine with aura can start very early. For example, among children who are still in elementary school and in girls near the menarche. The pathogenesis is very complex: there are neurotransmitter malfunctions and vascular problems. Which intertwine in a cascading sequence of events. During a migraine with aura, you can’t talk, you can’t work, and you can’t drive. It is a disabling disorder, but the positive note is that seizures usually occur with low frequency. Usually once a year. Stress, tension, fatigue, disordered rhythms of life can favor the attack and can increase its frequency, making it even multimonthly.
If migraine attacks with aura are frequent, therapy is done
Prophylaxis and prevention therapy with a drug to be taken every day is recommended only if the attacks occur several times a month. For a period of at least three months with even solo cardioaspirin. On the occasion of the attack, however, the therapy is very similar to that of migraine without aura: anti-inflammatory the eventually i triptani. “In addition to setting up a therapy when needed, it is important to teach patients how to manage attacks,” continues the neurologist. The first time migraine with aura can occur during physical exertion, it is therefore important to reassure the patient, but to complete the diagnosis with specific tests that exclude other pathological conditions of the central nervous system.
Diagnostic tests to rule out other neurological diseases
“It is essential to have a neurological examination from the first attack, addressing the headache centers that are present throughout Italy. The patient undergoes magnetic resonance to exclude different pathologies that express themselves with vascular malfunctions, such as neoplasms and various forms of epilepsy. During the neurological visit the patient’s medical history is reconstructed, a examination of reflexes and the functioning of the cranial nerves occurs. An in-depth diagnostic also includes a blood sample, through which thrombophilic screening factors are investigated, i.e. the possible tendency to cerebrovascular disease and a doppler transcranico which checks for the presence of a possible patent foramen ovale. This is a cardiac alteration, a hole that should physiologically close at birth, but which sometimes remains open, that is, and can favor any episodes of cerebral vascular suffering ».
Smoking and oral contraceptives are not recommended
Migraine in general is a female disease: it affects females three times more than males and even the type with aura is no exception to this rule. It should be remembered that smoking and oral contraceptives are not recommended and the possible intake of a contraceptive pill should always be carefully discussed with the reference neurologist if a form of migraine with aura is present.
Migraine with aura is affected by hormonal fluctuations
Migraine with aura is affected by hormonal fluctuations. It can occur in the first trimester of pregnancy, appears and then disappears in the premenopausal stage, and typically passes after menopause. External elements can also influence the attacks, such as changes in the pace of life. For example, going on vacation, paradoxically, can trigger attacks. Some precautions consist in adopting a regular healthy lifestyle, with breakfast in the morning, adequate sleep-wake rhythms, not smoking, doing physical activity, thus maintaining good physical and mental efficiency. This does not ensure the absence of episodes but it certainly can significantly reduce it.
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