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Different types of Migraines : Migraine with Aura

Migraine with aura

This is the second most commonly seen form of migraine: patients who primarily suffer from migraine with aura may also have attacks of migraine without aura. According to the International Classification of Headache Disorders^[11] it is a recurrent disorder manifesting in attacks of reversible focal neurological symptoms that usually develop gradually over 5-20 minutes and last for less than 60 minutes. Headache with the features of "migraine without aura" usually follows the aura symptoms. Less commonly, the aura may occur without a subsequent headache or the headache may be non-migrainous in type.

In order to diagnose migraine with aura, there must have been at least 2 attacks not attributable to another cause that fulfill the following criteria:

1. Aura consisting of at least one of the following, but no muscle weakness or paralysis:

Fully reversible visual symptoms (e.g. flickering lights, spots, lines, loss of vision)
Fully reversible sensory symptoms (e.g. pins and needles, numbness)
Fully reversible dysphasia (speech disturbance)

2. Aura has at least two of the following characteristics:

Visual symptoms affecting just one side of the field of vision and/or sensory symptoms affecting just one side of the body
At least one aura symptom develops gradually over more than 5 minutes and/or different aura symptoms occur one after the other over more than 5 minutes
Each symptom lasts from 5-60 minutes

Where these criteria are not fully met, a diagnosis of "probable migraine with aura" may be considered, although other neurological causes must also be excluded. If the picture complies with the criteria but includes one-sided muscular weakness or paralysis, a diagnosis of "sporadic hemiplegic migraine" or "familial hemiplegic migraine" should be considered.

Aura phase

For the 20-30%^[5]^[6] of migraineurs who suffer migraine with aura, the migraine aura comprises focal neurological phenomena that precede or accompany the attack. They appear gradually over 5 to 20 minutes and generally last less than 60 minutes. The headache phase of the migraine attack usually begins within 60 minutes of the end of the aura phase, but it is sometimes delayed up to several hours, and it can be missing entirely. Symptoms of migraine aura can be visual, sensory, or motor in nature.^[7]

Visual aura is the most common of the neurological events. There is a disturbance of vision consisting usually of unformed flashes of white and/or black or rarely of multicolored lights (photopsia) or formations of dazzling zigzag lines (scintillating scotoma; often arranged like the battlements of a castle, hence the alternative terms "fortification spectra" or "teichopsia"). Some patients complain of blurred or shimmering or cloudy vision, as though they were looking through thick or smoked glass, or, in some cases, tunnel vision and Hemianopsia. The somatosensory aura of migraine consists of digitolingual or cheiro-oral paresthesias, a feeling of pins-and-needles experienced in the hand and arm as well as in the ipsilateral nose-mouth area. Paresthesia migrate up the arm and then extend to involve the face, lips and tongue.

Other symptoms of the aura phase can include auditory or olfactory hallucinations, aphasia, vertigo, tingling or numbness of the face and extremities, and hypersensitivity to touch.

The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

5 or more attacks
4 hours to 3 days in duration
2 or more of - unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity
1 or more accompanying symptoms - nausea and/or vomiting, photophobia, phonophobia

For migraine with aura, only two attacks are required to justify the diagnosis.

Doctors say roller shoes injuring kids

By LINDSEY TANNER, AP Medical Writer Mon Jun 4, 12:24 AM ET

CHICAGO - Trendy wheeled sneakers that let kids zip down sidewalks, across playgrounds and through mall crowds could also send them rolling into emergency rooms on a stretcher, say doctors who blame a rash of injuries on the international craze.

It's called "heeling," named after Heelys, the most popular brand. They're sold in 70 countries and are so hot that their Carrollton, Texas, maker, Heelys Inc., recently landed atop BusinessWeek's annual list of fastest growing companies.
But doctors from Ireland to Singapore have reported treating broken wrists, arms and ankles; dislocated elbows and even cracked skulls in children injured while wearing roller shoes.

Over a 10-week period last summer, 67 children were treated for injuries from Heelys or strap-on wheels called Street Gliders at Temple Street Children's University Hospital in Dublin, Ireland, according to a report in the June edition of Pediatrics. From September 2005 through December 2006, one death and at least 64 roller-shoe injuries were reported to the U.S. Consumer Product Safety Commission, a spokesman said last week.

And doctors in Singapore reported last year that 37 children had been treated for similar injuries at a hospital there during a seven-month period in 2004. None were wearing protective gear.

The American Academy of Orthopaedic Surgeons, based in Rosemont, Ill., this week is issuing new safety advice that recommends helmets, wrist protectors and knee and elbow pads for kids who wear wheeled shoes.
"As these shoes are sold in department stores, parents buying them may develop a false sense of security — that they are like any other shoe," said Dr. James Beaty, academy president and a pediatric orthopedic surgeon in Memphis.
Heelys and their knockoffs look like gym shoes, but with wheel sockets in each heel. They can be used for walking, but the wheels pop out when users shift their weight to their heels.

Balancing on the wheels can be tricky, especially for novices. In the Irish study, most injuries were in new users and occurred when kids fell backward while trying to transfer their body weight.

Dr. Leon Benson of Evanston Northwestern Healthcare in Evanston, Ill., recalled treating a 9-year-old girl who'd had her Heelys for just a week when she fell and broke both wrists.

Nine-year-old Noah Woelfel of Davidsonville, Md., wasn't a novice but still tripped and fell, breaking several fingers and wrist bones in his right hand last year.

"All it took was a tiny piece of gravel in the driveway that went up in the wheel and stopped him cold," said his mother, Nancy. "He required surgery and pins, and he was six weeks without using his hand, right at the beginning of school."
She threw the removable wheels away and said other parents should know about the risks.

Dr. Dominic Catanese, a foot specialist at Montefiore Medical Center in New York, said balancing on heels can strain feet and Achilles tendons. He has treated several Heelys-related ankle injuries and won't let his 7-year-old daughter have the shoes.

"She wants them. Not happening. Just like I took away her trampoline" after reading about trampoline injuries. "It went right to Goodwill," Catanese said. Heelys in April said a study it commissioned shows that their shoes have a safer injury rate than skateboarding, inline skating and even swimming. The shoes are sold with safety information including a recommendation to wear protective gear.

The company says it has shipped more than 10 million pairs since their introduction in 2000. Heelys reported first-quarter income of $8.5 million, five times higher than last year. Still, some walkers find heelers who zip in and out of crowds a nuisance, and many schools and shopping malls have banned them.

On the Net:
American Academy of Pediatrics: http://www.aap.org
Heelys, Inc.: http://www.heelys.com
http://news.yahoo.com/s/ap/20070604/ap_on_he_me/roller_shoe_injuries;_ylt=AptU2ltBmBqAuCFQCD8y8D3MWM0F

Ben & Jerry's peach cobbler ice cream (allergy alert(

Ben and Jerry's Issues Allergy Alert on Undeclared Wheat in Ben and Jerry's Country Peach Cobbler Ice Cream (Fri, 16 Mar 2007 23:01:00 GMT) The following date codes: Jan 23, 2008; Jan 24, 2008; Feb 8, 2008; Feb 9, 2008 of Country Peach Cobbler are subject to the recall. The date code is found on the bottom of the pint.

Potato Salad Recall 03.19.07

Food and Drug Administration--Recalls

MDA Issues Consumer Advisory on Potato Salad (Mon, 19 Mar 2007 19:49:00 GMT) Minnesota Department of Agriculture (MDA) has issued an advisory for consumers to avoid eating selected lot codes of Coborn's, Cash Wise and Midwest Pride potato salad sold at stores in Minnesota and six other states due to concerns that the product may be contaminated with Listeria monocytogenes bacteria.

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