The search string was (((“migraine with aura”) OR “migraine aura”) AND visual ). We used the PubMed/MEDLINE database to identify published studies systematically investigating the clinical features of visual aura. The literature search was performed on June 1st 2018. Based on these data, we aimed to create a comprehensive list of the different types of EVSs including their respective frequency of occurrence. The aim of this article was to review all published studies providing systematic descriptions of VASs, with information on how frequently different EVSs are reported by MA patients. Improved clinical characterisation of MA will likely improve the diagnostic accuracy and identification of patient subgroups at risk of comorbidity. It is also often clinically challenging to differentiate MA from other conditions, particularly transient ischemic attacks and occipital epilepsy. MA is associated with an increased risk of ischemic stroke, atrial fibrillation, and patent foramen ovale.
An accurate description of the clinical features, in combination with investigations such as neuroimaging, is necessary to provide a better understanding of the underlying mechanisms.Įven more importantly, there are serious clinical issues related to MA that call for improved characterisation of the individual features. While MA is likely caused by cortical spreading depression, a transient wave of neuronal depolarization of the cortex, there is currently no pathophysiological explanation for the marked heterogeneity of visual symptoms. Several studies have investigated the clinical features of VASs but so far there is no consensus regarding which different types of EVSs occur during MA and there is no agreement on the terminology that should be used to describe EVSs. Viana and colleagues previously observed that these visual phenomena could be effectively defined by subdividing the perceived visual scenarios into so-called elementary visual symptoms (EVS), such as zigzag lines, crescent shapes, and flickering lights.
In clinical studies of VAS, patients have reported a plethora of different, often complex, visual disturbances. In addition to being the most common aura symptoms, VASs are also the most multifaceted. Visual aura symptoms (VASs) are by far the most common and occur in 98–99% of MAs, whereas disturbances of sensation and language occur in 36% and 10% of auras, respectively. Typical migraine aura (MA) symptoms are completely reversible visual, sensory, or language disturbances. Migraine with typical aura is a highly prevalent disorder as it affects 8% of the general population. We propose that, based on this work, an official list of VAS types should be developed, preferably within the context of the International Classification of Headache Disorders of the International Headache Society. We created a comprehensive list of VAS types reported by migraine patients based on all currently available data from clinical studies, which can be used for testing and validation in future studies.
The most common were flashes of bright light, “foggy” vision, zigzag lines, scotoma, small bright dots and ‘like looking through heat waves or water’. The number of different types of VASs reported by patients in the studies ranged from two to 23. We found 11 retrospective studies and three prospective studies systematically describing VASs. Main bodyĪ systematic review of previous prospective and retrospective systematic recordings of visual aura symptoms (VASs) was performed to provide an overview of the different types of visual phenomena occurring during MA and their respective frequencies in patients. Optimal clinical classification of MA symptoms is important for more accurate diagnosis and improved understanding of the pathophysiology of MA through clinical studies. MA is associated with an increased risk of cardiovascular disorders and is often clinically difficult to distinguish from other serious neurological disorders such as transient ischemic attacks and epilepsy. Migraine aura (MA) is a common and disabling neurological condition, characterized by transient visual, and less frequently sensory and dysphasic aura disturbances.
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