Content summary

Importance of migraine with aura in diagnosis

Migraine symptomology should be carefully analyzed due to the overlap with many other neurological disorders.
Migraine aura is the neurological signature of migraine and plays a pivotal role in migraine diagnosis in a subset of patients.
In migraine with aura, the aura can follow premonitory symptoms or precede headache, and persist through the headache phase.
In comparison, in migraine without aura the characteristics of the premonitory symptoms and headache are all that is available to make the diagnosis of migraine.
Aura can also occur without headache and premonitory symptoms, usually in older individuals who experience a flurry of attacks.

Why neurology is so important in teaching headache

Migraine informs how the brain is working in normal and abnormal states, an area there is still much to learn.
Neurology underlines clinical and basic science and is, therefore, an important subject to be taught.

Patient case studies remain an invaluable educational tool, demonstrating both classical and unusual migraine presentations that provide a source for differential diagnosis discussion.
Headaches have multiple phenotypes including migraine with aura, chronic migraine, cluster headaches and dangerous thunderclap headaches, which are of particular concern to clinicians.
Diagnosis should take into account the different location and physiology of blood vessels in the brain, particularly when considering a diagnosis of thunderclap headache.
Up until recently, physical examination and case history have been the foundations of understanding neurology and headache disorders.
Every interaction in educational, clinical medicine is picked up by the student, therefore, teachers have a tremendous influence on the outcomes.
It is important to remember it isn’t a disease or exam that sticks in the mind of a student, but how the subject was taught and in the context of a patient.