title: Transient Neurologic Deficits: Can Transient Ischemic Attacks Be Discriminated from Migraine Aura without Headache?
abstract: BACKGROUND
  Transient neurologic deficits (TNDs) are often considered first to be transient ischemic attacks (TIAs) but TND with normal brain imaging is also characteristic of other prevalent conditions like migraine aura leading to potential confusion. We aimed to determine if migraine aura with headache (MA) and migraine aura without headache (MAWH) can be distinguished from TIA on clinical or paraclinical ground using validated international criteria.
  
  
  METHODS
  Clinical and paraclinical data from 32 patients with TIA were compared with 32 patients with MAWH and 32 with MA. Participants underwent a thorough evaluation including standardized clinical examination, laboratory testing, magnetic resonance imaging of the brain, cardiovascular work-up, and electroencephalogram.
  
  
  RESULTS
  Patient with TIA were significantly older (65.41 ± 16.93 years) than patients with MAWH (50.41 ± 19.69, P = .002) or MA (40.56 ± 11.72, P = .00001), and were mostly male (male:female = .82) compared with the 2 other groups. History of stroke, high blood pressure, and dyslipidemia were significantly more frequent in patients with TIA. Visual deficits occurred in 63% of patients with MAWH, 41% for patients with MA, and 10% for patients with TIA. In patients with TIA, the TND was inaugural in 94% of cases, conversely to MAWH and MA in which TND was inaugural in only 19% and 38%, respectively (P ≤ .0001).
  
  
  CONCLUSIONS
  Despite some sociodemographic, clinical, and paraclinical differences in the presentation of these TND, there is no feature accurately distinguishing between TIA and TND associated with migrainous phenomena when validated actual criteria are used, leading to probable confusion in most studies. There is a need to develop reliable criteria and/or tests for this purpose.
authors: Department of Neurology, Hôpital Erasme Université Libre de Bruxelles, Bruxelles, Belgium.
authors: Yannick
authors: Y
authors: Fogang
authors: Department of Neurology, Hôpital Erasme Université Libre de Bruxelles, Bruxelles, Belgium. Electronic address: gilles.naeije@erasme.ulb.ac.be.
authors: Gilles
authors: G
authors: Naeije
authors: Department of Neurology, Hôpital Erasme Université Libre de Bruxelles, Bruxelles, Belgium.
authors: Noemie
authors: N
authors: Ligot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000175:diagnosis* / Q000503:physiopathology*; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D009460:Neurologic Examination; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: TIA; headache; migraine aura without headache; migraine with aura; stroke; transient neurologic deficits