A. At least two attacks fulfilling criteria B-E.
B. Fully reversible symptoms including motor weakness and at least one of the following: 1. visual, sensory, or speech disturbance.
C. At least two of the following:
1. At least one aura symptom develops gradually over at least 5 minutes or symptoms occur in succession.
2. Each aura symptom lasts less than 24 hours.
3. Some degree of headache is associated with the aura.
D. At least one first- or second-degree relative has migraine aura including motor weakness fulfilling criteria A, B, C, and E.
Adapted with permission from Thomsen LL, Eriksen MK, Roemer SF, Andersen I, Oleson J, Russell MB. A population-based study of familial hemiplegic migraine suggests revised diagnostic criteria Brain 2002;125;1379-1391, and from Oxford University Press.
revised diagnostic criteria. They are distinct from migraine primarily by their lack of nausea or vomiting, and the presence of either phono- or photophobia, but not both. From a clinical perspective, patients may have both classes of headaches at different times, and the criteria do not address issues of pathophysiology. The issue of neuroimaging is also not addressed by the criteria, and many secondary headaches, such as cerebral neoplasms, may present with headaches that fulfill the IHS criteria.
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