Presentation
A 22 year old male dancer presented via his optometrist following an episode of transient visual loss in his left eye. [ncbi.nlm.nih.gov]
Forms of Migraine that present with visual symptoms seem to be an area where there is a great amount of confusion, use of descriptions rather than formal diagnoses, and misdiagnosis. [migrainedisease.org]
It may be difficult to read and dangerous to drive a vehicle while retinal migraine symptoms are present. [en.wikipedia.org]
Like migraine with aura, retinal migraine may also present effects like nausea, vomiting, and light and sound sensitivity. [thehealthsite.com]
Entire Body System
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Falling
Although the descriptive terms may be used fairly frequently, the fall short of a diagnosis, and can mean entirely different things, depending upon who’s using them. [migrainedisease.org]
Skin
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Macula
(A) Left eye taken at routine optometrist appointment 1 month before presenting episode; normal appearance of disc, vessels, and macula. [ncbi.nlm.nih.gov]
Eyes
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Scotoma
Visual migraines result from cortical spreading depression and are also commonly termed scintillating scotoma. [en.wikipedia.org]
• There is a temporary vision loss or scotoma in one eye. The vision loss may be complete or partial and usually doesn’t last for more than an hour. • The blindness may be complete or partial. • Vision loss is accompanied by a headache. [thehealthsite.com]
A retinal Migraine attack begins with monocular (in one eye) visual symptoms that can include: scintillations (seeing twinkling lights) scotoma (areas of decreased or lost vision) temporary blindness. [migrainedisease.org]
[…] conventional forms of migraine, and exercise may precipitate the attacks. 2 Vasospasm of the retinal circulation or ophthalmic artery is thought to be the cause of the amaurosis of ocular migraine. 1– 5 Ischaemic optic neuropathy 6 and permanent arcuate scotomas [ncbi.nlm.nih.gov]
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Scintillating Scotoma
Visual migraines result from cortical spreading depression and are also commonly termed scintillating scotoma. [en.wikipedia.org]
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Retinal Pallor
pallor 4 The optic discs may be pale 1, 2, 5 early and hyperaemic later. 4, 7 Early isolated constriction of veins has been reported, 1, 10 which may be segmental, 1 as well as simultaneous constriction of arterioles and veins. 2 Later engorgement of [ncbi.nlm.nih.gov]
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Unilateral Blindness
Ocular migraine in a young man resulting in unilateral blindness and retinal oedema. J Pediatric Ophthalmol 1971; 8 :173–6. [ Google Scholar ] 5. Winterkorn JMS, Kupersmith MJ, Wirtschafter JD, et al. [ncbi.nlm.nih.gov]
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Transient Blindness
With Retinal Migraine, it is essential that other causes of transient blindness be fully investigated and ruled out. [migrainedisease.org]
Psychiatrical
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Suggestibility
One study suggests that more than half of reported recurrent cases of retinal migraine subsequently experienced permanent visual loss in that eye from infarcts, [1] but more recent studies suggest such loss is a relatively rare side effect. [5] See also [en.wikipedia.org]
Neurologic
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Aura
aura symptoms last 5-60 minutes the aura is accompanied, or followed within 60 minutes, by headache Not better accounted for by another ICHD-3 diagnosis, and other causes of amaurosis fugax have been excluded. [migrainedisease.org]
However, some overlap is seen between retinal migraine and migraine with aura says the doctor. “In 25 percent of retinal migraine cases, some symptoms of migraine with aura can be seen.” [thehealthsite.com]
The terms "retinal migraine" and "ocular migraine" are often confused with " visual migraine ", which is a far-more-common symptom of vision loss, resulting from the aura phase of the common migraine. [en.wikipedia.org]
Diagnostic criteria: Attacks fulfilling criteria for 1.2 Migraine with aura and criterion B below Aura characterized by both of the following: fully reversible, monocular, positive and/or negative visual phenomena (eg, scintillations, scotomata or blindness [ichd-3.org]
He described similar episodes every 2–3 months for the previous 3 years with no associated migrainous aura or headache, and exercise was not a trigger. [ncbi.nlm.nih.gov]
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Throbbing Headache
A throbbing headache follows the sudden blindness, and then, minutes later, the vision returns. The episode of blindness in one eye may be temporary but it is a nightmarish situation for someone undergoing it. [thehealthsite.com]
Symptoms [ edit ] Retinal migraine is associated with transient monocular visual loss ( scotoma ) in one eye lasting less than one hour. [1] During some episodes, the visual loss may occur with no headache and at other times throbbing headache on the [en.wikipedia.org]
Treatment
A normal retina exam is consistent with retinal migraine. [4] Treatment [ edit ] Treatment depends on identifying behavior that triggers migraine such as stress, sleep deprivation, skipped meals, food sensitivities, or specific activities. [en.wikipedia.org]
Brief report: treatment of vasospastic amaurosis fugax with calcium channel blockers. N Engl J Med 1993; 329 :396–9. [ PubMed ] [ Google Scholar ] 6. Walsh FB, Hoyt AB. Clinical Neuro-ophthalmology. Baltimore: Williams and Wilkins, 1969:1671. 7. [ncbi.nlm.nih.gov]
Retinal Migraine Treatment: For infrequent attacks, medications used for other forms of Migraine are often employed to relieve the other symptoms. These medications can include NSAIDs, antinausea medications, ergotamines the triptans. [migrainedisease.org]
Prognosis
Medicines used to treat retinal migraines include aspirin, other NSAIDS, and medicines that reduce high blood pressure. [4] Prognosis [ edit ] In general, the prognosis for retinal migraine is similar to that of migraine headache with typical aura. [en.wikipedia.org]
Pathophysiology
Though migraine pathophysiology is controversial, vasospasm remains a possible contributor/epiphenomenon in retinal migraine. 1 Study funding No targeted funding reported. Disclosure The authors report no disclosures relevant to the manuscript. [n.neurology.org]
Prevention
When Migraines are frequent, the same preventive therapies used for other forms of Migraine can be explored. [migrainedisease.org]
When considered necessary, effective treatments include propranolol, 10 verapamil, 5 and nifedipine. 2, 5 Prophylactic aspirin or nifedipine may be tried to prevent exercise induced attacks, 2 and inhaled amyl nitrate can be used early in an attack to [ncbi.nlm.nih.gov]