Abstract
Migraine is a common headache disorder characterized by often-severe headaches that may be preceded or accompanied by a variety of visual symptoms. Although a typical migraine aura is not difficult to diagnose, patients with migraine may report several other visual symptoms, such as prolonged or otherwise atypical auras, “visual blurring”, “retinal migraine”, “ophthalmoplegic migraine”, photophobia, palinopsia, and “visual snow”. Here, we provide a short overview of these symptoms and what is known about the relationship with migraine pathophysiology. For some symptoms, the association with migraine is still debated; for other symptoms, recent studies indicate that migraine mechanisms play a role.
Highlights
Symptoms related to the visual system are common in migraine, a neurovascular brain disorder characterized by episodes of often-severe headache lasting between 4 hours and 3 days[1]
In almost one third of patients with migraine, the headache is preceded by a visual aura[2] but there are several other visual symptoms related to migraine
The purpose of this narrative review is to provide a brief overview of these visual symptoms
Summary
Symptoms related to the visual system are common in migraine, a neurovascular brain disorder characterized by episodes of often-severe headache lasting between 4 hours and 3 days[1]. Occipital epilepsy can present with visual symptoms followed by headache but without the characteristic motor seizures Patients describe these symptoms as colored phosphenes[3], phosphenes can be reported as aura symptoms by patients with migraine[20]. Visual symptoms in epilepsy generally last shorter than 5 minutes and often start in the periphery of one temporal visual field whereas in migraine the auras generally start more to the center and expand to the periphery[20] These criteria are not specific and sometimes electro-encephalography recordings could help in diagnosing occipital seizures. Persistent migraine auras often start unilaterally and expand whereas patients with visual snow generally report that it started in the entire visual field and there was no spatial expansion[50]. Lamotrigine may sometimes help[63,64]
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