Clinical neurophysiology of migraine with aura

Table 1 Synoptic table of neurophysiological changes comparing episodic migraine with aura (MA) between attacks, during the aura phase, and familiar hemiplegic migraine (FHM). Arrows indicate the direction of change

	Episodic migraine with aura between attacks	Episodic migraine during the aura	FHM
Technique
EEG & MEG	↑ photic driving, ↑ of slow, and hyper synchronized alpha rhythmic activity	On EEG, mild asymmetry of slow waves contralateral to the visual fiend defect	Unilateral or bilateral delta EEG activity – sometimes spreading postero-anteriorly – and ↓ of alpha
		On MEG, alpha and gamma rhythm ERD contralateral to the visual fiend defect, slow direct current potential shifts
EP & ERP grand-average	↑ amplitude (more than in MO) or normal, ↓ thalamocortical activity	↓ or abolition of cortical EPs in the hemisphere contralateral to the field defect
EP & ERP Habituation	↓ habituation (more than in MO) or normal	↓ habituation during persistent aura without infarction	Significantly more pronounced habituation during VEPs and nBR recordings than controls
TMS	Paradoxical effects to enhancing and reducing paradigms of stimulation		↓ MEP amplitude on the ictally paretic side
EMG recordings	↓ Habituation of nBR, subclinical abnormalities of neuromuscular transmission on SFEMG

EEG electroencephalography, EMG electromyography, EP, evoked potentials (visual, somatosensory and auditory), ERD event-related desynchronization, ERP event-related potentials, MEG magnetoelectroencephalography, MEP motor evoked potential, MO episodic migraine without aura, nBR nociceptive blinck reflex, TMS transcranial magnetic stimulation

ISSN: 1129-2377