![]() Interictal photosensitivity associates with altered brain structure in patients with episodic migraine. ![]() ‘Visual snow' - a disorder distinct from persistent migraine aura. Schankin CJ, Maniyar FH, Digre KB, Goadsby PJ. Persistent positive visual phenomena in migraine. Liu GT, Schatz NJ, Galetta SL, Volpe NJ, Skobieranda F, Kosmorsky GS. Visual auras can be debilitating, instilling fear in patients during highly demanding visual tasks such as driving because these auras interfere with the visual field.ġ. Examples include bilateral metamorphopsia, micropsia or macropsia, halos, kaleidoscopic or fractured scenes, sensation of looking through waves of heat or water, persistence of visual imagery (palinopsia), or loss of color vision (achromatopsia).Ī migraine patient may experience any single or combined version of the aforementioned visual symptoms, which completely reverse, have a stereotyped pattern for each patient, and can change over a lifetime (see Visual Snow). The patient's visual perception misrepresents reality (Figure, right). Areas of vision are missing, such as homonymous field loss, constriction of the visual field-often described as tunnel vision-scotomas, or a total loss of vision in either or both eyes (Figure, center). These are the classic migraine aura descriptions of scintillating scotoma or fortification spectra (Figure, left). The patient sees things that are not there, including lights, patterns, or something obstructing vision. 1: Positive visual phenomena/hallucinations. ![]() Visual disturbances seen in migraine aura may be divided into three types. More cautious usage of that term is warranted, however, because it can imply a visual migraine aura that presents bilaterally with intracranial pathology, or it can refer to a retinal migraine with vasospastic vision loss in one eye. The term ocular migraine is commonly used to refer to painless, typical visual auras. It is usually followed by headache but can occur in isolation without reported pain. Aura is often unilateral and dynamic and involves at least one positive visual phenomenon. 1 AURAĪura in migraine consists of recurrent attacks of unilateral, fully reversible visual, sensory, or other central nervous system symptoms that evolve over minutes and last less than an hour (most commonly 10–30 minutes). The headache is accompanied by at least nausea and/or vomiting or by photophobia and/or phonophobia.
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