Do you treat migraine with aura if there is not an associated headache/pain?

It is officially called migraine aura without headache, but I like to refer to it as isolated migraine aura. Although a migraine aura can be visual, somatosensory, or involve speech, the presentation in practice, in my experience, is always visual.

The best way to diagnose it is by having the patien...

I do if it interferes with quality of life.

I do not recommend abortive medications for aura. There is no evidence that migraine abortive treatments shorten the duration of aura. I do not think that they do. Anecdotally, I have had some patients report that taking NSAIDs or a triptan at the aura ons...

In an older patient over 50 years of age who has never had a migraine attack, if they start having typical auras without pain, I usually do not treat. If they are frequent and/or always unilateral on the same side, and might do a workup, and if normal, consider putting them on Vitamin B6, 200 mg bid...