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IHS Diagnosis ICD-10
1.2.3 Typical aura without headache G43.104  


Typical aura consisting of visual and/or sensory symptoms with or without speech symptoms. Gradual development, duration no longer than one hour, a mix of positive and negative features and complete reversibility characterise the aura which is not associated with headache.

Diagnostic criteria:

  1. At least 2 attacks fulfilling criteria B-D
  2. Aura consisting of at least one of the following, with or without speech disturbance but no motor weakness:
    1. fully reversible visual symptoms including positive features (eg, flickering lights, spots or lines) and/or negative features (ie, loss of vision)
    2. fully reversible sensory symptoms including positive features (ie, pins and needles) and/or negative features (ie, numbness)
  3. At least two of the following:
    1. homonymous visual symptoms1 and/or unilateral sensory symptoms
    2. at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms occur in succession over ≥5 minutes
    3. each symptom lasts ≥5 and ≤60 minutes
  4. Headache does not occur during aura nor follow aura within 60 minutes
  5. Not attributed to another disorder2


  1. Additional loss or blurring of central vision may occur.
  2. History and physical and neurological examinations do not suggest any of the disorders listed in groups 5-12, or history and/or physical and/or neurological examinations do suggest such disorder but it is ruled out by appropriate investigations, or such disorder is present but attacks do not occur for the first time in close temporal relation to the disorder.


In some patients a typical aura is always followed by migraine headache, but many patients have, in addition, attacks with aura followed by non-migraine headache or even without headache. A small number of patients have 1.2.3 Typical aura without headache exclusively. More commonly, as patients with 1.2.1 Typical aura with migraine headache become older, their headache may lose migraine characteristics or disappear completely even though auras continue. Some individuals, primarily males, have 1.2.3 Typical aura without headache from onset.

In the absence of headache fulfilling criteria for 1.1 Migraine without aura, precise diagnosis of aura and its distinction from mimics that may signal serious disease (eg, transient ischaemic attack) become much more important. This distinction may require investigation. Especially if aura begins after age 40, if negative features (eg, hemianopia) are predominant, or if aura is prolonged or very short, other causes should be ruled out.