12/21/2023 0 Comments Aura migraine![]() The authors concluded that a relationship exists between the pathophysiology of migraine, visual field defects and glaucomatous optic neuropathy. The researchers also noticed a tendency of pain and visual field defects to develop ipsilaterally was noticed. ![]() Risk of having glaucomatous-like defects was higher in the patients who had migraine attacks once a month or less frequently. Some additional findings: The glaucomatous group was significantly older, with a significantly higher age of onset for migraine. IOP was within normal limits on all patients. 11 They found that 62% of the patients had glaucomatous visual field defects, primarily a nasal step defect. Researchers looked at glaucomatous visual field defects in 77 patients who had a history of either a common migraine or a classic migraine (with aura). ![]() Is there a link between glaucoma and migraines? A study reported earlier this year suggests so. Research has also indicated that ischemia and inflammation (as in temporal arteritis) can cause a visual disturbance mimicking a migraine prodrome in as many as 75% of all patients. 5-7 (For more on glaucoma, see Glaucoma and Aura: A Coincidence?). Several studies suggest that a possible link exists between migraines (or at least the prodrome) and glaucoma seizures, as in patients with epilepsy and compression from space-occupying lesions. However, the diagnosis may be especially challenging when the aura appears without the headache (called an acephalic migraine).Īn additional diagnostic challenge: When the aura occurs for the first time in individuals above age 50, when there is a persistent visual field loss, or when there are simultaneous neurological findings such as pupil abnormalities or nerve palsies. 4Ī diagnosis of migraine is often straightforward, especially when a patient presents with an aura followed by a fairly intense headache. The researchers reproduced this pattern using orientation maps of the primary visual cortex, and found that the discontinuous repetitive nature of the zigzag pattern can reflect the specific layout of the visual cortical orientation maps. In a study in Germany, the most common form of visual hallucination reported is known as the fortification illusion, which appears as a typical zigzag pattern. Individuals who suffer from classic migraines report a diversity of migraine auras. What does this mean for your exam? If the patient complains of a persistent after-image after youve completed ophthalmoscopy, you might then question the patient about a history of migraine headaches. 3 There was no difference between classic or common migraine patients. A visual pattern such as a scintillating scotoma is by far the most common prodrome, although the prodrome may also be somatosensory, such as an enhanced scent ability.Īnother study found that patients with migraines complained more often of an after-image than did non-migraine patients. 2Ībout one-third to one-half of all migraine patients experience an aura, or prodrome. Ajamian, O.D.Ĭlassic migraine, in which the patient experiences an aura such as a scintillating scotoma, prior to a headache.Ĭommon migraine, in which there is no prodrome, or aura, before the headache. ![]() 1 Generally, there are two types:Ībout one-third to one-half of migraine patients experience an aura. Well look at the clinical studies related to this condition for all ages and determine whether we must consider the zigzag pattern as more than just a simple insignificant migraine prodrome.Ībout 20% of women and 10% of men suffer from migraine headaches sometime in their lives, and about half to two-thirds of them will have had a migraine attack within the previous year. Is this significant, or is it simply a case of late onset migraine prodrome? He did not experience any headache after the prodrome but has had three separate episodes of a scintillating scotoma pattern in the last month. He had no history of migraine headaches, nor had he experienced an episode of a migraine prodrome or aura until now. A 70-year-old male recently presented with an onset of a scintillating scotoma.
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