Patients' resources > Literature highlights

Literature highlights

A helpful scale for the diagnosis of migraine with aura

Migraine with aura is characterized by the presence of a transitory neurological disturbance that precedes the appearance of the headache. The authors of this article have developed a special scale for the measurement of the major symptoms of migraine aura. This scale can be used to support diagnosis according to the International Headache Classification of Headache Disorders (ICHD-II). As in 99% of cases, migraine aura consists of visual disturbances that may or may not be associated with numbing of the limbs and speech impairment, the scale is basically centred on the quantification of visual symptoms and is called visual aura rating scale (VARS). The sample used to develop VARS was made up of 427 patients suffering from migraine with aura according to the ICHD-II criteria. The diagnosis was based on a semi-structured interview conducted by a specially trained physician. The patients were divided into two groups: in the first group, using a statistical analysis the authors identified the features of visual aura that were most characteristic of this symptom and were to form the rating basis of VARS, while in the second group they tested the performance of VARS to validate it. VARS consists of 5 items, each of which carries an individual score. VARS scoring is 3 points for duration of aura between 5 and 60 minutes, 2 points for gradual development of aura over 5 minutes or more, also 2 points for the presence of light or dark spots (so-called "scotomas") or light zig-zag lines, and 1 point for the location of symptoms on one side only. Based on the visual symptoms reported by the patients, it is possible to obtain a total score represented by the sum total of the individual scores of each characteristic that is actually present in the migraine attack. The maximum total score that can be obtained is 10. A score of or over 5 suggests a diagnosis of migraine with aura. VARS revealed a sensitivity of 96% and a specificity of 98% in the first group of patients, and a sensitivity of 91% and a specificity of 96% in the second group (validation sample). Sensitivity and specificity rates close to 100% mean that the tested diagnostic tool is accurate and reliable. Therefore, VARS is a user-friendly tool that is easy to learn, to apply and to teach, and represents a helpful diagnostic aid for the diagnosis of migraine with visual aura.

The Visual Aura Rating Scale (VARS) for migraine aura diagnosis.

Eriksen MK, Thomsen LL, Olesen J.

Cephalalgia 2005;25:801-10

This page last modified: 27/03/2006