• Jakob M Hansen, Richard B Lipton, David W Dodick, Stephen D Silberstein, Joel R Saper, Sheena K Aurora, Peter J Goadsby, and Andrew Charles.
• Headache Research and Treatment Program, Albert Einstein College of Medicine, Bronx, NY, USA.
• Neurology. 2012 Nov 13;79(20):2044-9.

ObjectivesMigraine aura is commonly considered to be a distinct phase of a migraine attack that precedes headache. The objective of the study was to examine a large number of prospectively recorded attacks of migraine with aura and determine the timing of headache and other migraine symptoms relative to aura.MethodsAs part of a clinical trial we collected prospective data on the time course of headache and other symptoms relative to the aura. Patients (n = 267) were enrolled from 16 centers, and asked to keep a headache diary for 1 month (phase I). They were asked to record headache symptoms as soon as possible after aura began and always within 1 hour of aura onset. A total of 456 attacks were reported during phase I by 201 patients. These patients were then randomized and included in phase II, during which a total of 405 attacks were reported in 164 patients. In total, we present data from 861 attacks of migraine with aura from 201 patients.ResultsDuring the aura phase, the majority of attacks (73%) were associated with headache. Other migraine symptoms were also frequently reported during the aura: nausea (51%), photophobia (88%), and photophobia (73%). During the first 15 minutes within the onset of aura, 54% of patients reported headache fulfilling the criteria for migraine.ConclusionOur results indicate that headaches as well as associated migraine symptoms are present early, during the aura phase of the migraine attack in the majority of patients.

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