Conclusions To summarize, this study shows that the clinical heterogeneity of migraine with aura is reflected in distinct visual evoked potential profiles. Patients with complex neurological auras differ from those with strictly visual auras by an interictal increase of VEP amplitudes suggestive of an underlying genuine persistent visual cortical hyperexcitability. Whether this is related to CSD features, their effect on cortex and thalamus or to a common neurobiological or genetic denominator between CSD and VEP profile determinants remains to be determined.