Orgasmic migraine aura: Report of two cases

• Published in: Cephalalgia Vol. 39; no. 1; pp. 153 - 156
• Main Authors: Angus-Leppan, Heather, Caulfield, Alice
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2019
• Subjects: Adult; Epilepsy - etiology; Female; Humans; Male; Migraine with Aura - etiology; Orgasm; Young Adult; primary headache associated with sexual activity; orgasmic migraine; migraine with aura; reversible cerebral vasoconstriction syndrome; Migraine; post-orgasmic illness syndrome
• ISSN: 0333-1024; 1468-2982; 1468-2982
• DOI: 10.1177/0333102418771373

Background Paroxysmal neurological symptoms occurring with sex cause considerable anxiety and sometimes have a serious cause. Thunderclap headache is the most well-known and requires urgent investigation at first presentation for subarachnoid haemorrhage and other significant pathologies. After exclusion of underlying causes, many prove to be primary headache associated with sexual activity. Orgasmic migraine aura without headache is not currently recognised as a clinical entity. Case reports We report two patients with acephalgic orgasmic neurological symptoms fulfilling the criteria for migraine aura. Conclusions The incidence of acephalgic orgasmic migraine aura is unknown. It should be considered as part of the differential of paroxysmal sex-related neurological symptoms, and clinically differentiated from fixed deficits, reversible cerebral vasoconstriction syndrome and post-orgasmic illness syndrome.