Findings in an adult with migraine that mimics a TIA:
(1) older adult with transient neurological symptoms suspicious for a TIA
(2) negative cerebral angiography
(3) no evidence of a cardiac, cerebrovascular, coagulation or seizure disorder
Clues to the diagnosis:
(1) headache associated with the neurological symptoms
(2) visual scintillations
(3) characteristic features of an episode:
(3a) buildup and migration of visual scintillations
(3b) march of paresthesias
(3c) progression from one accompaniment to another
The diagnosis may be made once 2 or more episodes have occurred that follow a similar course. Improvement in symptoms after therapy for migraine would support the diagnosis.
The diagnosis may be difficult if the patient has evidence of TIA, cardiac disease, etc.
