Acephalgic migraine

An acephalgic migraine — a variant of migraine, that manifests by a prodromal period and an aura without subsequent occurrence of headache is described in the article. According to the International classification of headache it is designated by code 1.2.1.2. as typical aura without headache. This condition occurs in 1–3% of migraine cases, more often in older women, who previously suffered from migraine attacks with headache. The pathophysiology of acephalgic migraine is similar to classic migraine. The cause of the aura is a wave of depolarization of the membranes of neurons and glial cells of the cerebral cortex, which moves across the surface of the brain from the occipital cortex to the somatosensory and frontotemporal areas, and is combined with a deterioration of regional cerebral blood flow in a certain area of the brain, which leads to cerebral hypoperfusion and the appearance of various auras. Features of the clinical symptomatology of acephalgic migraine are described — signs of the prodromal period, positive and negative symptoms of mainly visual aura. It is emphasized that the absence of headache, the acute onset and transient nature of aura symptoms often complicate the differential diagnosis of acephalgic migraine. The clinical differences between acephalgic migraine, transient ischemic attack and epilepsy with occipital paroxysms are given.