Migraine aura without headache: prevalence and risk factors in a primary eye care population.

BACKGROUND: Although migraine headache has received substantial attention in the scientific literature, migraine aura without headache (MAWOH) has not been investigated frequently. A general population survey study estimated the lifetime prevalence of MAWOH to be 1% in males and 3% in females. Anecdotal evidence has suggested that MAWOH is encountered by primary eye care practitioners more frequently than these rates suggest. This study is the first investigation of this condition in a primary eye care population. METHODS: A written questionnaire was used to survey 1,000 patients, ages 18 years and older, presenting for a comprehensive eye examination in the Primary Care Optometry Service of the School of Optometry, University of Alabama at Birmingham. Cases were identified by the presence of visual sensations consistent with MAWOH. RESULTS: Of the primary eye care population surveyed, 6.5% reported experiencing visual sensations consistent with MAWOH. The prevalence in males was 2.9% and in females, 8.6%. A multivariate analysis revealed that female gender (odds ratio [OR] = 2.3), history of migraine headaches (OR = 3.2), and history of childhood motion sickness (OR = 2.7) were significantly related to MAWOH. CONCLUSIONS: The prevalence of MAWOH is higher in an adult primary eye care population than previously reported in a general population study.

Changes in the discharge patterns of cat motor cortex neurones during unexpected perturbations of on-going locomotion.

1. The impulse activity of single neurones in the forelimb part of the motor cortex was recorded extracellularly in unrestrained cats during self-paced locomotion on a horizontal circular ladder. 2. Fifty-one cells (forty-nine of which discharged rhythmically in time with the step cycle) were recorded during encounters with a number of rungs that could be locked firmly in position or, alternatively, held in position by weak springs so that when stepped on they unexpectedly descended (under the weight of the animal) from 1 to 5 cm before contacting a mechanical stop. 3. In eleven cells (22%) including four fast-axon pyramidal tract neurones (PTNs), an increase in discharge occurred when the contralateral forelimb descended unexpectedly. Onset latency relative to the start of rung movement ranged from ca 20 to ca 100 ms. In eight cells latency was such that most of the response preceded contact of the rung with the stop; averaged over a number of trials the altered discharge in five of these cells (including two PTNs) represented an accurate profile of the averaged velocity of rung (and foot) descent. The three remaining cells appeared to be responding largely to the cessation of rung movement. 4. Thirty-six of the cells were also studied during unexpected descent of the ipsilateral forelimb and six (17%) displayed an increase in discharge (onset latency ca 35 to ca 80 ms); three of these were among those that also responded to contralateral descents. 5. These findings for skilled locomotion requiring a high degree of visuomotor coordination are discussed and it is concluded that the motor cortex is rapidly informed regarding unexpected perturbations delivered to the contralateral forelimb at the onset of stance and that changes are evoked in the pattern of impulse traffic descending via the pyramidal tract.