Raieli Vincenzo, Capizzi Mariarita, Marino Antonio, Di Nardo Giovanni, Raucci Umberto, Parisi Pasquale
Child Neuropsychiatry Unit ISMEP, ARNAS Civico Palermo, Via dei Benedettini 1, P.O. Di Cristina, 90134 Palermo, Italy.
Child Neuropsychiatry School, University of Palermo, 90128 Palermo, Italy.
Life (Basel). 2022 Mar 18;12(3):450. doi: 10.3390/life12030450.
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: "".
偏头痛是一种复杂的神经系统疾病，中枢神经系统的多个系统（自主神经系统、情感、认知、感觉和运动系统）可能在不同层面受到影响。约四分之一的偏头痛患者有偏头痛先兆。最常见的先兆是视觉先兆，其次是感觉先兆，但也可能出现运动功能缺损以及高级皮质中枢功能缺损（思维、定向、连贯或注意力障碍）。与头痛日记类似，先兆日记在罕见偏头痛表现的诊断过程中可提供重要帮助，并防止对不寻常偏头痛表现的漏诊。复杂偏头痛表现是一种排除性诊断，为排除危险的神经病理学情况，需要进行广泛的诊断检查。此外，在此我们讨论发育年龄阶段这些非典型偏头痛先兆特征的非典型临床表现及可能的生理 - 病理发生相关方面。此外，我们想强调并分析我们患有非典型先兆的儿童/青少年的临床情况，这些情况似乎更难用最初提出的解释皮层扩散性抑制（CSD）与先兆之间生理 - 病理发生关系的机制来界定。最后，我们根据现有数据详细讨论该主题的复杂方面，并提出新术语：“”
