Late onset and early onset aura: the same disorder

Late onset aura (LOA) is usually considered benign but raises diagnostic uncertainties. We compared individuals with LOA (>45 years of age at aura onset) with those of early onset (EOA) in clinical features, vascular risk factors and imaging, in a retrospective study design including patients with migraine aura and age >44 years at first visit. In 77 cases (51 EOA and 26 LOA), no differences were found in gender distribution, family or personal history of migraine without aura, type of aura symptoms or imaging findings. LOA patients’ were more likely to not fulfil all ICHD-II aura criteria and to lack headache. This data suggest that LOA and EOA are overall identical but there are differences in presentation that deserve a better characterization by a prospective study.