Underestimated phenomena: Higher cortical dysfunctions during migraine aura

Abstract

Introduction: Aura occurs in 20-30% of patients with migraine. Some descriptions of aura go far beyond the most frequent visual and sensory symptoms, suggesting the involvement of different cortical areas. The aim of this prospective study was to evaluate the frequency and types of disorders of higher cortical functions (HCF) that occur during visual and/or sensory aura. Methods: We interviewed 60 patients with visual and/or sensory aura about HCF disorders of praxia, gnosia, memory, and speech, during aura. Patients were divided into two groups, with and without HCF disorders, and were compared in terms of demographic data and aura characteristics. Results: From all 60 patients, 65% reported at least one HCF disorder during aura. The patients with HCF disorders had longer-lasting auras (28.51±16.39 vs. 19.76±11.23, p=0.016). The most common HCF disorders were motor dysphasia (82.05%) and dysnomia (30.74%). Motor dysphasia was more often reported by patients with visual as well as sensory aura (p=0.002). The number of HCF disorders correlated with the aura duration (p=0.003). Conclusion: According to our results, HCF disorders during aura occur more often than previously thought. The aura duration has some influence on the HCF disorders. © 2013 International Headache Society.