1.2.1.1 Typical aura with headache

A 41-year-old software engineer describes a lead-in to his headaches. He has experienced this only twice in his life. He reports a creeping pins-and-needles feeling that starts around his lips and travels up into his cheek, and once that settles, a spell of stumbling over his words for a minute or two before speaking normally again; the whole build-up develops gradually rather than all at once, taking close to half an hour, about 32 minutes by his own timing, to run its course, and both times followed within the hour by a pounding, one-sided headache with nausea that sent him to bed. He denies any double vision, unsteadiness or ringing in his ears during these spells, and reports no arm, face or leg weakness whatsoever. He has never noticed loss of vision in one eye alone.