Migraine with and without aura – two different entities?

Migraine is one of the most common neurological disorders, and for decades it has been debated whether migraine with aura (MwA) and migraine without aura (MwoA) are merely different manifestations of the same disease or whether they are two distinct entities. A recent narrative review in the Journal of Headache and Pain summarizes the available data on epidemiology, genetics, clinical characteristics, neuroimaging and treatment response. The result: there is increasing evidence that the two subtypes differ not only in terms of symptoms, but also in their biological basis. For neurologists, this raises the question of whether understanding these differences should also have diagnostic and therapeutic consequences in the future.