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Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases

Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensory and motor system) may be affected on different levels. About a fourth of migraine patients have migraine auras. The most common aura is the visual aura f...

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Autores principales: Raieli, Vincenzo, Capizzi, Mariarita, Marino, Antonio, Di Nardo, Giovanni, Raucci, Umberto, Parisi, Pasquale
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954623/
https://www.ncbi.nlm.nih.gov/pubmed/35330201
http://dx.doi.org/10.3390/life12030450
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author Raieli, Vincenzo
Capizzi, Mariarita
Marino, Antonio
Di Nardo, Giovanni
Raucci, Umberto
Parisi, Pasquale
author_facet Raieli, Vincenzo
Capizzi, Mariarita
Marino, Antonio
Di Nardo, Giovanni
Raucci, Umberto
Parisi, Pasquale
author_sort Raieli, Vincenzo
collection PubMed
description Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensory and motor system) may be affected on different levels. About a fourth of migraine patients have migraine auras. The most common aura is the visual aura followed by the sensorial aura but motor deficits, as well as deficits of higher cortical centers (disorders of thinking, orientation, coherence, or concentration), may occur as well. In analogy with a headache diary, an aura diary can deliver important help in the diagnostic process of rare migraine manifestations and prevent the under-diagnosis of unusual migraine manifestations. Complex migraine manifestations are a diagnosis of exclusion, and a broad diagnostic work-up is necessary in order to exclude dangerous neurologic pathologies. In addition, here, we discuss the atypical clinical presentation and possible physio-pathogenetic related aspects of these atypical migraine aura features in the developmental age. In addition, we wanted to stress and analyze the clinical aspects of our children/adolescents with atypical auras, which seem to be more difficult to frame with the mechanisms originally proposed to explain the physio-pathogenetic relationship between CSD and aura. Finally, we discuss in detail the complex aspects of this topic on the basis of available data and propose new terminology: “Multiple, Synchronous and Asynchronous, Cortical and Subcortical Spreading Depression”.
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spelling pubmed-89546232022-03-26 Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases Raieli, Vincenzo Capizzi, Mariarita Marino, Antonio Di Nardo, Giovanni Raucci, Umberto Parisi, Pasquale Life (Basel) Article Migraine is a complex neurologic disorder by which several systems of the central nervous system (autonomous system, affective, cognitive, sensory and motor system) may be affected on different levels. About a fourth of migraine patients have migraine auras. The most common aura is the visual aura followed by the sensorial aura but motor deficits, as well as deficits of higher cortical centers (disorders of thinking, orientation, coherence, or concentration), may occur as well. In analogy with a headache diary, an aura diary can deliver important help in the diagnostic process of rare migraine manifestations and prevent the under-diagnosis of unusual migraine manifestations. Complex migraine manifestations are a diagnosis of exclusion, and a broad diagnostic work-up is necessary in order to exclude dangerous neurologic pathologies. In addition, here, we discuss the atypical clinical presentation and possible physio-pathogenetic related aspects of these atypical migraine aura features in the developmental age. In addition, we wanted to stress and analyze the clinical aspects of our children/adolescents with atypical auras, which seem to be more difficult to frame with the mechanisms originally proposed to explain the physio-pathogenetic relationship between CSD and aura. Finally, we discuss in detail the complex aspects of this topic on the basis of available data and propose new terminology: “Multiple, Synchronous and Asynchronous, Cortical and Subcortical Spreading Depression”. MDPI 2022-03-18 /pmc/articles/PMC8954623/ /pubmed/35330201 http://dx.doi.org/10.3390/life12030450 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Raieli, Vincenzo
Capizzi, Mariarita
Marino, Antonio
Di Nardo, Giovanni
Raucci, Umberto
Parisi, Pasquale
Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
title Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
title_full Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
title_fullStr Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
title_full_unstemmed Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
title_short Study on “Atypical” Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases
title_sort study on “atypical” migraine auras in the pediatric age: the role of cortical spreading depression and the physiopathogenetic hypothesis arising from our clinical cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954623/
https://www.ncbi.nlm.nih.gov/pubmed/35330201
http://dx.doi.org/10.3390/life12030450
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