Abstract
Migraine, the most frequent neurological ailment, affects visual processing during and between attacks. Most visual disturbances associated with migraine can be explained by increased neural hyperexcitability, as suggested by clinical, physiological and neuroimaging evidence. Here, we review how simple (e.g., patterns, color) visual functions can be affected in patients with migraine, describe the different complex manifestations of the so-called Alice in Wonderland Syndrome, and discuss how visual stimuli can trigger migraine attacks. We also reinforce the importance of a thorough, proactive examination of visual function in people with migraine.
Highlights
Genes that have been associated with certain types of migraine, including the familial hemiplegic migraine CACNA1A, ATP1A2, and SCN1A genes [2], alter this balance in favor of increased excitability; (2) Abnormalities in the thalamus, which plays a major role in cortical excitability control [3]—in a study where we examined thalamus microstructure using a multiparametric approach, we showed microstructural differences in the lateroposterior and the pulvinar nuclei of patients with migraine compared with healthy control participants
Batelli et al [7] applied their stimulations more anteriorly and laterally, and examined visual cortical excitability by stimulating over area MT/V5 in their migraine with aura (MWA) and migraine without aura (MWoA) patients
Face processing is a complex system that involves a network of brain areas, comprising the occipital face area (OFA) and the fusiform face area (FFA)
Summary
Vision consumes a substantial portion of brain processing in humans. The most frequent neurological ailment, affects vision more than any other cerebral function, both during and between attacks. Visual experiences in patients with migraine vary vastly in nature, extent and intensity, suggesting that migraine affects the central nervous system (CNS) anatomically and functionally in many different ways, thereby disrupting several components of visual processing. Migraine visual symptoms are simple (positive or negative), or complex, which involve larger and more elaborate vision disturbances, such as the perception of fortification spectra and other illusions [1]. Based on the physiology of vision, migraine visual manifestations may serve as clues to a better understanding of the mechanisms underlying this intriguing condition. We provide a narrative review of visual manifestation associated with migraine
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