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Migraine with Typical Aura — SCE Neurology MCQ

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EasyHeadache & Facial PainMigraine with Typical AuraSCE Neurology

A 35-year-old woman presents with episodes of right arm numbness lasting 20–30 minutes, preceded by visual scintillations (zigzag lines) in the left visual field that march across her vision over 5 minutes. She then develops a mild right-sided headache. She has no motor symptoms and no loss of consciousness. Between episodes, neurological examination is entirely normal. MRI brain is normal. What is the most likely diagnosis?

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Correct answer: A — Migraine with typical aura

Migraine with typical aura is characterised by fully reversible visual, sensory, or speech symptoms that develop gradually over 5–60 minutes (the 'march'), followed by headache. The visual aura (scintillating scotoma, zigzag lines, fortification spectra) is the most common type. Sensory aura (numbness, tingling) often follows the visual aura. Normal MRI and neurological examination between attacks support the diagnosis. A: TIA symptoms are maximal at onset and do not 'march'. C: Seizures spread more rapidly and may cause positive motor phenomena. D: TGA affects memory. E: FND has positive examination signs.

Reference: ICHD-3 (2018); NICE CG150