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Saturday, 23 November 2013

Migraine with Aura - The Symptoms

I. Migraine with Aura defined as condition of common migraine, involves migraine headaches that are preceded by some sort of visual disturbance of an aura such as difficulty speaking, vertigo, ringing in ears, or a number of other brainstem-related symptoms, but sometimes it may be associated with underlying hereditary or acquired cerebrovascular disorders, according to " Migraine aura pathophysiology: the role of blood vessels and microembolisation"
Dalkara T, Nozari A, Moskowitz MA.(1)

II. Symptoms
1. Difficulty speaking
It can be a result of the mirgaine with aura has interfered with the brain or nerves that control the facial muscles, larynx, and vocal cords necessary for speech.

2. Vertigo
Feeling of movement when in fact in stationary. although
migraine, dizziness, and vertigo are all common in the general population, affecting 13%, 20-30%, and 5-10% respectively, complaints of dizziness or vertigo appear to be relatively common accompaniments of migraine, particularly migraine with aura, and prevalence increases with age(II.2)

3. Blind spots (scotomas)
It can be a result of the migraine of aura has obstructed nerve fibers route before the retina, blocking some light of that create a blind spot where the fibers pass through the retina and out of the eye.

4. Shimmering spots or stars
It is caused by spreading depression in the occipital cortex, at the back of the brain

5. Changes in vision
As the disease process, it can create a state of neuronal hyperexcitability, leading to an individual's susceptibility to the development of cortical spreading depression, the electrophysiological correlate of the visual aura(II.5)

6. Flashes of light
It is also caused by by spreading depression in the occipital cortex, at the back of the brain

7. Feelings of numbness
As a result of migraine with aura has interfered pressure on the nerves of the spine or on peripheral nerves from enlarged blood vessels

8. Muscle weakness
It can be caused by temporary block off acetylcholine receptors at the postsynaptic neuromuscular junction, as a result of interference of neurotransmitters' function before onset of headache

9. Bilateral facial pain
Some patient with history of Migraine with Aura may be experience bilateral facial pain radiating bilaterally accompanied by scotomas in the right visual field and hypaesthesia in both upper limbs(II.9)

10. Ringing in the ear
It may be a result of the migraine of aura that lead to pathologic changes in the cochlear neurotransmission,

11. The Alice in wonderland syndrome
The Alice in Wonderland syndrome is defined as a condition of perceptual distortion of one's body size and shape. The Alice in Wonderland syndrome is associated with a transient dysfunction of associative somatosensory areas in the parietal cortex(II.10)

11. Etc.
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/20170844
(II.2) http://www.ncbi.nlm.nih.gov/pubmed/21797862
(II.5) http://www.ncbi.nlm.nih.gov/pubmed/21335146
(II.9) http://www.ncbi.nlm.nih.gov/pubmed/22407662
(II.10) http://www.ncbi.nlm.nih.gov/pubmed/22406233