The Difference Between Epileptic Auras and Migrainous Auras in the 19th Century

Abstract

In the International Headache Society classification of headaches, the concept of aura is given a key role. It serves as a boundary between ‘migraine without aura’ and ‘migraine with aura’. Historically, the concept of an aura was borrowed from the epilepsy vocabulary; a borrowing that took place in English medicine at the beginning of the 19th century and in French medicine in the mid-19th century. It would therefore be interesting to see which features of the epileptic aura are used to explain the migraine aura. Based on the French and English medical literature of the 19th century, two processes have been reviewed: (i) the emergence of the concept of aura, and (ii) the modifications of this concept throughout the 19th century. It appears that the original medical use of the term ‘aura’ as a set of rising tactile sensations was in use from the 2nd century until late in the 19th century, but then various other symptoms were recognized and the aura gradually became accepted as an early part of the seizure. By the end of the 19th century the aura that preceded a migraine was seen as a similar process, and thought of as part of the migraine sequence.