Differential Diagnosis for Aura Followed by Vomiting
Single Most Likely Diagnosis
- Migraine: This is the most likely diagnosis because auras are a common precursor to migraine headaches, and vomiting can occur during or after the headache phase, especially if the migraine is severe or if the patient experiences significant nausea.
Other Likely Diagnoses
- Epilepsy (specifically, a seizure with a post-ictal phase that includes vomiting): Some seizures, particularly those involving the temporal lobe, can present with an aura (which might be a subjective experience or an observable change in behavior) followed by a seizure and then a post-ictal phase where vomiting could occur.
- Vestibular Migraine: This condition involves vertigo or imbalance as a prominent symptom, often accompanied by headache, nausea, and vomiting. An aura could precede the onset of vertigo or headache.
- Cyclical Vomiting Syndrome: Although less common, this condition involves recurrent episodes of severe vomiting that can be preceded by an aura or prodrome, which might include headache or other migraine-like symptoms.
Do Not Miss Diagnoses
- Brain Tumor: Although rare, a brain tumor could cause increased intracranial pressure leading to symptoms like vomiting and could potentially cause auras if the tumor affects areas of the brain involved in seizure activity or other neurological functions.
- Subarachnoid Hemorrhage: This is a medical emergency where bleeding into the space surrounding the brain can cause sudden, severe headache (often described as "the worst headache" ever), nausea, vomiting, and sometimes an aura-like phenomenon if the bleed irritates the brain's surface.
- Meningitis or Encephalitis: Infections of the meninges or brain can cause severe headache, fever, nausea, vomiting, and sometimes an aura if the infection affects specific areas of the brain.
Rare Diagnoses
- Porphyria: A group of disorders that can cause acute episodes of neurological symptoms, including abdominal pain, nausea, vomiting, and sometimes neurological symptoms that could be mistaken for an aura.
- Chiari Malformation: A structural defect in the cerebellum that can cause increased intracranial pressure and lead to symptoms like headache, nausea, vomiting, and potentially aura-like phenomena due to compression of brainstem structures.