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Background  There is limited literature on prolonged aura (PA - defined as an aura including at least one symptom for > 1 h and < 7d), and there are no prospective studies.  The aim of this study is to characterize prospectively the phenotype and prevalence of PA.    Findings  Two hundred and twenty-four patients suffering from migraine with aura were recruited from the Headache Centers of Pavia and Trondheim. Patients prospectively described, on an ad hoc diary, each aura symptom (AS), the duration of AS and headache, and headache features. Seventy-two patients recorded three consecutive auras in their diaries. 19 (26.4%) of patients suffered at least one PA. Out of 216 recorded auras, 38 (17.6%) were PAs. We compared PAs with non-PAs with respect to 20 features; PAs were characterized by a higher number of non-visual symptoms (non-VS) ( p  < 0.001). No other differences were found. We obtained similar results when we compared auras with at least one symptom with a duration of > 2 h ( n  = 23) or > 4 h ( n  = 14) with the the others ( n  = 193 and  n  = 202 respectively).    Conclusion  PAs are quite common. They do not differ from the other auras (even when their duration extends to 2 and/or 4 h) with the exception of a higher number of non-VS.

Prolonged migraine aura: new insights from a prospective diary-aided study