Migraine with aura
Description?
Typical aura consisting of visual and/or sensory and/or speech symptoms. Preceded by a visual aura scotoma, flashlight, black and white line of vision, blurred vision, during 10-20 minutes.Then unilateral head pain that lasts more severe between 1-6 hours but sometimes longer, many symptoms often found are nausea, vomiting, photophobia, phonophobia, iritable and malaise.
Patofisiology?
Patofisiology of migraine with aura , known as the theory of cortical spreading depression (CSD). Aura occurs because there is excitation of neuron in substansia nigra spreads with the speed of 2-6 mm / min. The spread is followed by supression neuron wave with a similar pattern so formed of vasodilatation rhythm followed by a vasoconstriction. The principle is neurochemical CSD releases potassium or amino acid glutamat excitatori from the network so nervous going depolarisation and releases more neurotransmitter, depression, nervous even spread. CSD in the episode aura will stimulate nervus trigeminalis nucleuscaudatus, start of a migraine
Diagnostic criteria
A. At least 2 attacks fulfilling Headache lasting 4 to 72 hours (untreated or unsuccessfully treated)a
B. At least 3 of the following 4 characteristics:
1. One or more fully reversible aura symptoms indicating focal cerebral cortical and/or brain stem dysfunction
2. At least one aura symptom develops gradually over more than 4 minutes or 2 or more symptoms occur in succession
3. No aura symptom lasts more than 60 minutes. If more than one aura symptom is present, accepted duration is proportionally increased
4. Headache follows aura with a free interval of less than 60 minutes. (It may also begin before or simultaneously with the aura)
C. At least one of the following:
1. History, physical and neurological examinations do not suggest one
of the disorders listed in groups 5-11
2. History andlorphysical and/or neurological examinations do suggest such disorder, but it is ruled out by appropriate investigations
3. Such disorder is present, but migraine attacks do not occur for the first time in close temporal relation to the disorder
Diagnosis criteria in children:
1. In children, attacks may last 1–72 hours.
2. The headache of a Migraine attack is commonly bilateral (on both sides) in young children; an adult pattern of unilateral pain usually emerges in late adolescence or early adulthood.
3. In young children, photophobia and phonophobia may be inferred from observing their behavior.
4. The headache of a Migraine attack is usually frontotemporal (front and sides, toward the front, of head). Occipital (lower back of the head) headache in children, whether unilateral or bilateral, is rare and calls for caution in diagnosing as many cases are attributable to structural lesions.
refference:
1. www.healthcentral.com
2. http://astaqauliyah.com
3. http://www.kalbe.co.id
Description?
Typical aura consisting of visual and/or sensory and/or speech symptoms. Preceded by a visual aura scotoma, flashlight, black and white line of vision, blurred vision, during 10-20 minutes.Then unilateral head pain that lasts more severe between 1-6 hours but sometimes longer, many symptoms often found are nausea, vomiting, photophobia, phonophobia, iritable and malaise.
Patofisiology?
Patofisiology of migraine with aura , known as the theory of cortical spreading depression (CSD). Aura occurs because there is excitation of neuron in substansia nigra spreads with the speed of 2-6 mm / min. The spread is followed by supression neuron wave with a similar pattern so formed of vasodilatation rhythm followed by a vasoconstriction. The principle is neurochemical CSD releases potassium or amino acid glutamat excitatori from the network so nervous going depolarisation and releases more neurotransmitter, depression, nervous even spread. CSD in the episode aura will stimulate nervus trigeminalis nucleuscaudatus, start of a migraine
Diagnostic criteria
A. At least 2 attacks fulfilling Headache lasting 4 to 72 hours (untreated or unsuccessfully treated)a
B. At least 3 of the following 4 characteristics:
1. One or more fully reversible aura symptoms indicating focal cerebral cortical and/or brain stem dysfunction
2. At least one aura symptom develops gradually over more than 4 minutes or 2 or more symptoms occur in succession
3. No aura symptom lasts more than 60 minutes. If more than one aura symptom is present, accepted duration is proportionally increased
4. Headache follows aura with a free interval of less than 60 minutes. (It may also begin before or simultaneously with the aura)
C. At least one of the following:
1. History, physical and neurological examinations do not suggest one
of the disorders listed in groups 5-11
2. History andlorphysical and/or neurological examinations do suggest such disorder, but it is ruled out by appropriate investigations
3. Such disorder is present, but migraine attacks do not occur for the first time in close temporal relation to the disorder
Diagnosis criteria in children:
1. In children, attacks may last 1–72 hours.
2. The headache of a Migraine attack is commonly bilateral (on both sides) in young children; an adult pattern of unilateral pain usually emerges in late adolescence or early adulthood.
3. In young children, photophobia and phonophobia may be inferred from observing their behavior.
4. The headache of a Migraine attack is usually frontotemporal (front and sides, toward the front, of head). Occipital (lower back of the head) headache in children, whether unilateral or bilateral, is rare and calls for caution in diagnosing as many cases are attributable to structural lesions.
refference:
1. www.healthcentral.com
2. http://astaqauliyah.com
3. http://www.kalbe.co.id
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