Long-lasting reversible monocular visual loss of retinal migraine
- PDF / 887,379 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 42 Downloads / 195 Views
LETTER TO THE EDITOR
Long‑lasting reversible monocular visual loss of retinal migraine Sang‑Hun Lee1 · Ji Hye Shin1 · Jung Won Hwang1 Received: 20 July 2020 / Accepted: 15 September 2020 © Belgian Neurological Society 2020
Keywords Retinal migraine · Monocular visual loss · Long-lasting visual loss · Headache
Introduction Transient monocular visual disturbance associated with retinal migraine often occurs for a short duration and usually improves quickly. Hence, it is difficult to perform tests for monocular visual loss during an attack. The International Classification of Headache Disorders Third Edition (ICHD3) criteria for visual symptoms of retinal migraine include a symptom duration of 5–60 min and an attack of completely reversible monocular visual loss [1]. Herein, we report a case of retinal migraine in a patient who met the diagnostic criteria of ICHD-3 for visual symptoms, wherein monocular visual loss lasted for 20 h and a detailed examination of monocular vision was performed during the attack. We present detailed test results during the symptom attack and the association between long-lasting visual loss and retinal migraine.
Case report A 26-year-old woman was hospitalized for headaches and sudden monocular visual impairment. She was generally healthy with no specific underlying diseases, but was diagnosed with migraines with aura 4 years prior. There was no family history of migraine. Her headaches began above the left temple, lasted 5–8 h, and occurred on average once a month. The headaches were moderate to severe, pulsating, and left-sided. Associated features included photophobia, phonophobia, nausea, and vomiting. During a migraine 2 weeks earlier, she experienced her first visual loss in the * Sang‑Hun Lee [email protected] 1
left eye that lasted for 10 min and recovered completely. A day before her hospital admission, she experienced a second complete visual loss in the left eye that lasted for 40 min, which then fully resolved and was immediately followed by a migraine. Furthermore, 24 h after the second visual loss, a third complete visual loss occurred, and she visited the emergency room. The patient confirmed the monocular nature of her attacks by alternately covering each eye during the attacks. The patient had no recent history of trauma and had not been prescribed any new drugs. Upon admission, her blood pressure was 107/59 mmHg, pulse was 65 bpm, body temperature was 36.6 °C, and breathing was 20 breaths/min. No specific findings were observed during physical or neurological examinations, except for headache and monocular visual impairment. Magnetic resonance imaging (MRI) was performed because of the possibility of secondary headaches. No structural lesions, such as brain tumors, acute cerebral infarction, or cerebral hemorrhage, were observed by MRI or contrast-enhanced MR angiography. Automated static perimetry (ASP), performed in the ictal stage, revealed complete monocular blindness in the left eye (Fig. 1a). However, fundus photography revealed normal findings without s
Data Loading...
