Differential Diagnosis for Aura, No Head Pain, Vomiting

• Single Most Likely Diagnosis
  • Migraine with aura (without headache phase): This condition is characterized by an aura phase that can include neurological symptoms such as visual disturbances, followed by vomiting, but without the headache phase that typically accompanies migraines. The presence of an aura and vomiting without head pain makes this a plausible diagnosis.
• Other Likely Diagnoses
  • Gastroparesis: This condition involves delayed stomach emptying, which can lead to nausea, vomiting, and abdominal discomfort. While not typically associated with an aura, some patients might experience premonitory symptoms that could be mistaken for an aura.
  • Cyclical Vomiting Syndrome: Characterized by recurrent episodes of severe vomiting, this condition can sometimes be preceded by an aura-like phase. The absence of head pain and the presence of vomiting fit this diagnosis.
• Do Not Miss Diagnoses
  • Brain Tumor: Although less likely, a brain tumor could potentially cause symptoms of an aura followed by vomiting due to increased intracranial pressure or local effects on brain structures. Missing this diagnosis could be catastrophic.
  • Subarachnoid Hemorrhage: While typically associated with a severe headache, in some cases, especially if the hemorrhage is small, patients might experience an aura-like phenomenon followed by vomiting without significant head pain. This is a medical emergency.
• Rare Diagnoses
  • Porphyria: A group of disorders that can result in acute episodes of neurological symptoms, including vomiting and abdominal pain, sometimes preceded by an aura-like phase. These conditions are rare but can be severe.
  • Mitochondrial Disorders: Certain mitochondrial disorders can cause a wide range of neurological symptoms, including episodes that might resemble an aura followed by vomiting. These conditions are rare and often involve other systemic symptoms.