Sporadic hemiplegic migraine
Description: Migraine with aura including motor weakness but no first- or second-degree relative has aura including motor weakness.
Diagnostic criteria:

1. At least 2 attacks fulfilling criteria B and C

2. Aura consisting of fully reversible motor weakness and at least one of the following:

   1. 1. fully reversible visual symptoms including positive features (e.g., flickering lights, spots or lines) and/or negative features (i.e., loss of vision)

   2. 2. fully reversible sensory symptoms including positive features (i.e., pins and needles) and/or negative features (ie, numbness)

   3. 3. fully reversible dysphasic speech disturbance

3. At least two of the following:

   1. 1. at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms occur in succession over ≥5 minutes

   2. 2. each aura symptom lasts ≥5 minutes and <24 hours

   3. 3. headache fulfilling criteria B–D for Migraine without aura begins during the aura or follows onset of aura within 60 minutes

4. No first- or second-degree relative has attacks fulfilling these criteria A–E

Comments:
Epidemiological studies have shown that sporadic cases occur with approximately the same prevalence as familial cases. The attacks have the same clinical characteristics as those in Familial hemiplegic migraine. Sporadic cases always require neuroimaging and other tests to rule out other cause. A lumbar puncture is also necessary to rule out pseudomigraine with temporary neurological symptoms and lymphocytic pleocytosis. This condition is more prevalent in males and often associated with transient hemiparesis and aphasia.

Migraine without aura
Description:
Recurrent headache disorder manifesting in attacks lasting 4–72 hours. Typical characteristics of the headache are unilateral location, pulsating quality, moderate or severe intensity, aggravation by routine physical activity and association with nausea and/or photophobia and phonophobia.
Diagnostic criteria:

1. At least 5 attacks1 fulfilling criteria B–D

2. Headache attacks lasting 4–72 hours (untreated or unsuccessfully treated)

3. Headache has at least two of the following characteristics:

   1. unilateral location

   2. pulsating quality

   3. moderate or severe pain intensity

   4. aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)

4. During headache at least one of the following:

   1. nausea and/or vomiting

   2. photophobia and phonophobia