The Menagerie of Migraine

David W. Buchholz, Stephen G. Reich

Research output: Contribution to journalArticlepeer-review


Migraine is conventionally regarded as a specific type of headache with a small set of associated neurologic symptoms. Yet, the true scope and frequency of migrainous phenomena are much greater than is generally acknowledged. Six cases are presented to illustrate some of the diverse manifestations of migraine: (1) transient global amnesia, (2) persistent visual phenomena, (3) migraine and seizures, (4) vestibular dysfunction, (5) hearing loss, and (6) migraine masquerading as multiple sclerosis. These and other migraine-associated neurologic symptoms are discussed in relation to previous reports in the literature. Pitfalls in recognizing the diverse manifestations of migraine, which are often underdiagnosed or misdiagnosed, are reviewed. Whether or not the established diagnostic criteria for migraine are too strict, other factors contributing to failure to identify migraine when it causes nonclassic neurologic symptoms include: (1) the belief that these are rare, (2) lack of an objective measure for migraine, (3) inadequate attention to the positive diagnostic features of migraine in the absence of headache, (4) confusion regarding prior migraine history, and (5) dismissing the diagnosis because of reported failure of prior migraine treatment. Recognition of the diversity of migraine helps avoid unnecessary testing and opens the door to effective treatment.

Original languageEnglish (US)
Pages (from-to)83-93
Number of pages11
JournalSeminars in neurology
Issue number1
StatePublished - Mar 1996


  • "Otic" migraine
  • Basilar migraine
  • Benign recurrent syncope
  • Migraine
  • Status migrainosus
  • Transient global amnesia
  • Vertigo

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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