Up to a third of people with migraine experience aura, the visual and sensory disturbances that precede or accompany attacks, and for some patients the aura itself is the most disabling part of the disease. Yet there is currently no established treatment that specifically targets it. In Sweden, around 1.5 million people live with migraine, and an estimated 50,000 have an aura-dominant form in which these episodes dominate the clinical picture.
Researchers at Lund University, including physician Gürdal Sahin and doctoral student Sena Uzun, reviewed records from 81 patients treated between 2014 and 2022 with lamotrigine, an anti-epileptic drug. Average monthly aura days fell from 6.9 to 1.4, a reduction of about 80 per cent, and among patients with aura-dominant migraine, 85 per cent experienced at least a halving of their aura days. Slower dose escalation was associated with fewer side effects. The findings appear in Frontiers in Neurology.
The rationale is biological: epilepsy and migraine aura both involve temporary disturbances in nerve cell activity, so a drug that stabilises neuronal excitability might plausibly prevent aura. The study was observational, with no control group, and the authors are explicit that the association must be confirmed before practice changes. They now plan a national, randomised, double-blind, placebo-controlled trial, which could establish an inexpensive and well-characterised option for a neglected patient group.