No significant clinical differences have been found between individuals with cluster headache who experience aura vs no aura, according to a study published in Headache.

This cross-sectional study included 629 individuals with cluster headache, 585 (93%) of whom did not experience aura and 44 (7%) who did. Among the 44 participants who experienced aura, the majority (n=27; 61.4%) reported visual symptoms, 17 reported sensory symptoms, 12 reported dysarthria, and 10 reported dysphasia. These included both overlap and isolated dysarthric, sensory, and aphasic symptoms that manifested in the absence of visual symptoms. Although 70.4% of visual symptoms manifested before the onset of cluster headache, dysarthric, sensory, and aphasic symptoms typically began while the headache was ongoing. There were no major clinical differences between the individuals with vs without aura, with the exception of lower consumption of alcohol and greater frontal pain in those with aura.

Participants in this study were gathered as part of the Leiden University Cluster Headache program. They were at least 18 years of age and believed, whether personally or through diagnosis, that they experienced cluster headache. The researchers used validated questionnaires administered over the web to investigate aura characteristics and clinical features. Those who fit qualifications for aura were assessed further by telephone to assess whether they met the International Classification for Headache Disorders-3 criteria for aura.

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The researchers concluded that “[at] least 7.0% of the participants with cluster headache in our large cohort reported typical aura symptoms, which most often involved visual symptoms. No major clinical differences were found between participants with and without aura.”


de Coo IF, Wilbrink LA, Ie GD, Haan J, Ferrari MD. Aura in cluster headache: A cross-sectional study [published online June 22, 2018]. Headache. doi: 10.1111/head.13344