Migraine with visual aura

• Published in: Journal francais d'ophtalmologie Vol. 39; no. 6; p. 554
• Main Authors: Bidot, S, Biotti, D
• Format: Journal Article
• Language: French
• Published: France 01-06-2016
• Subjects: Cortical Spreading Depression - physiology; Headache - complications; Headache - diagnosis; Humans; Migraine Disorders - classification; Migraine Disorders - diagnosis; Migraine Disorders - epidemiology; Migraine Disorders - therapy; Migraine with Aura - diagnosis; Migraine with Aura - epidemiology; Migraine with Aura - etiology; Migraine with Aura - therapy; Scotoma - complications; Scotoma - diagnosis; Fortification spectrum; Trouble visuel transitoire; Céphalée; Scotome scintillant; Migraine; Headaches; Transient visual disturbance; Aura
• ISSN: 1773-0597
• DOI: 10.1016/j.jfo.2016.05.002

Migraine with visual aura is marked by recurrent episodes of transient visual disturbance, often followed by headaches. Its pathophysiology has not been fully understood, but visual auras might be related to a self-propagating wave of cortical depolarization called "cortical spreading depression", triggering a trigemino-vascular "storm" ultimately leading to headaches. The most specific visual symptom is the "fortification spectrum" consisting of glimmering jagged lines spreading from the center to the periphery, and leaving a transient scotoma in its wake. Other visual symptoms are numerous, ranging from elementary positive or negative visual phenomena to complex and elaborate hallucinations. The diagnosis can be made according to the International Classification of Headache Disorders revised in 2013. The main goal of the treatment is to relieve the patient's pain quickly and to decrease the frequency of the episodes.