Prolonged aura, often characterized by nonvisual symptoms, is prevalent among migraineurs and tends not to differ from other auras, according to a study published in the Journal of Headache and Pain. In addition, the researchers found that prolonged auras, in comparison with other auras, were associated with a greater number of symptoms and a higher frequency of both dysphasic aura and sensory aura symptoms.
A total of 224 successive patients with migraine with aura for at least one year were enrolled. Study investigators instructed participants to prospectively record 3 consecutive migraine attacks and their characteristics in an ad hoc aura diary. Each recording described the visual, sensory, and dysphasic aura symptoms, as well as the duration of the headache and aura symptoms. After the recording of all 3 episodes, a neurologist and the patient discussed their recordings to verify the symptoms.
Of the 72 patients who recorded 3 consecutive auras, 19 (26.4%) reported at least 1 prolonged aura whereas 38 (17.6%) of the 216 recorded auras were considered prolonged auras. In comparison with other aura types, prolonged auras were associated with a higher number of total symptoms (P <.001) and greater frequency of sensory (P <.001) and dysphasic (P <.001) symptoms. When the investigators compared prolonged aura with auras with at least one symptom lasting longer than 2 hours or longer than 4 hours, prolonged aura was associated with a greater frequency of sensory symptoms (P =.001) and a higher number of aura symptoms (P =.005).
A limitation of the study included the recruitment of patients from only tertiary headache centers, which reduced the generalizability of the findings across the entire migraine population.
“Our findings indicate the need to reconsider the use of the term ‘prolonged aura’ and the duration of aura symptoms that should be classed as a typical or prolonged auras,” the investigators concluded.
Viana M, Sances G, Linde M, et al. Prolonged migraine aura: new insights from a prospective diary-aided study. J Headache Pain. 2018;19(1):77.