Migraine-Like Positive Visual Phenomena Related to Focal Cortical Lesions with Undetectable Visual Field Defects

We present 4 patients (3 females and 1 male) with an average age of 48.5 (range 28 –67) years who had migraine-like visual disturbances related to a right temporal meningioma, occipital cavernoma, occipital lobe infarction, and demyelination in the optic radiations, which was the presenting sign of multiple sclerosis. No patient underwent neurosurgical intervention, and 1 patien t (occipital lobe infarct) had complete resolution of the symptom after initial presentation. All patients had normal visual fields at follow-up and no thinning evident on optical coherence tomography. Our cases emphasize the importance of a history in assessing patients with transient positive visu al phenomena and identify pathology that may present without visual field defects. Clinical features that should raise a doubt about a diagnosis of migraine visual aura include the absence of headache, brief visual disturbance lasting #x3c;5 min or those lasting #x3e;60 min, and age #x3e;40, especia lly with no past medical history of migraine.Case Rep Ophthalmol 2021;12:653 –658
Source: Case Reports in Ophthalmology - Category: Opthalmology Source Type: research