Purpose of Review

To provide an updated review of the pathophysiology, diagnosis, and management of migraine with aura.

Recent Findings

Thalamic and other subcortical regions may play a role in the pathophysiology of migraine. There is inter-patient and intra-patient attack variability in the characteristics of typical aura especially visual aura symptoms. Migraine with brainstem aura may originate cortically. Migraine with retinal aura may be associated with structural and functional changes in the retina.

Summary

Although cortical spreading depression (CSD) continues to be the predominant theory surrounding the pathophysiology of migraine with aura, the exact mechanism of action of CSD and its role in relation of all phases of migraine including features of aura are not fully understood. Novel experimental models and newer diagnostic tools including neuroimaging are currently being used to enhance of understanding of migraine with and without aura. Transient ischemia attacks, stroke, and epilepsy should be considered in your differential diagnosis of migraine with aura. There are no specific therapies for migraine with aura.

中文翻译：

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偏头痛光环：病理生理学和管理的最新进展。

审查目的

提供偏头痛先兆的病理生理学，诊断和治疗的最新综述。

最近的发现

丘脑和其他皮质下区域可能在偏头痛的病理生理中起作用。典型先兆的特征，尤其是视觉先兆症状的特征在患者之间和患者之间具有发作差异。脑干先兆偏头痛可能起源于皮质。具有视网膜先兆的偏头痛可能与视网膜的结构和功能改变有关。

概要

尽管皮质散布性抑郁症（CSD）仍然是围绕偏头痛与先兆的病理生理的主要理论，但尚不完全了解CSD的确切作用机制及其在偏头痛所有阶段（包括先兆特征）之间的关系。目前正在使用新型实验模型和包括神经影像学在内的新型诊断工具来增强对有或没有先兆的偏头痛的理解。鉴别偏头痛与先兆时应考虑短暂性脑缺血发作，中风和癫痫。没有偏头痛先兆的具体疗法。