Have You Seen A Kaleidoscope? A Case of Visual Migraine Aura

Fatimah Lateef

doi:10.31579/2692-9392/095

Abstract

This is a case of migraine, presenting with the interesting visual aura of a ‘kaleidoscope’: waves with flickering movements made up of a variety of colors (red, blue, green, yellow), commencing laterally and spreading superiorly in the visual field of the left eye. This description is quite similar to a fortification spectrum, which usually expands and spreads in a C-shape fashion over one side of the visual field. Several different possible pathophysiological explanation are shared as well as the common differential diagnoses. In the work up of a patient with visual aura migraine, a comprehensive and detailed history is important, together with the appropriate investigations, in order not to miss any serious syndromes, including stroke syndromes and epilepsy.

Highlights

This is a case of migraine, presenting with the interesting visual aura of a ‘kaleidoscope’: waves with flickering movements made up of a variety of colors, commencing laterally and spreading superiorly in the visual field of the left eye
This description is quite similar to a fortification spectrum, which usually expands and spreads in a C-shape fashion over one side of the visual field
In the approach to a patient presenting with migraine with aura, it is important to get a comprehensive history and rule out possible differential diagnoses

Summary

Discussion

In the approach to a patient presenting with migraine with aura, it is important to get a comprehensive history and rule out possible differential diagnoses. Whilst having arrhythmia such as atrial fibrillation (AF) can predispose one to stroke and transient ischemic attacks (TIA), many older patients and those with conditions such as valvular heart disease may have both AF and migraine. Symptoms such as homonymous visual disturbance can happen in both stroke and migraine as well. If unsure in any circumstances, it will be better to admit the patient for further investigations. [2,8, 12, 14]

Findings

Conclusion

Headache Classification Committee of the International Headache Society