Migraines are painful and potentially debilitating. Most doctors diagnose based on the International Headache Society’s International Classification of Headache Disorders, 2nd Edition (ICHD-II).
A “standard” makes communications easier when patients need to consult or change doctors. Retinal migraine, an actual migraine diagnosis, is when there are recurrent attacks of visual disturbances prior to the headache phase of the migraine attacks.
There are no tests to confirm this type of migraine. Diagnosis is made by reviewing the patient’s medical history, symptoms, examination, and ruling out other causes for the symptoms.
Retinal Migraine Symptomology
Retinal migraines begin with monocular (in one eye) visual symptoms including:
1. scintillations (seeing twinkling lights)
2. scotoma (areas of decreased or lost vision)
3. temporary blindness
The headache phase of a retinal migraine begins during, or within 60 minutes of, the visual symptoms.
This phase presents symptoms consistent with migraine without aura:
· Headache duration of 4-72 hours
· At least two of these characteristics:
1. unilateral (on one side) location
2. pulsatile quality (pulsing or throbbing)
3. moderate or severe pain intensity
4. aggravation by routine physical activity such as walking or climbing stairs
· At least one of these characteristics:
1. nausea and/or vomiting
2. photophobia (sensitivity to light) and phonophobia (sensitivity to sound)
Differentiating factors between retinal migraine and migraine with aura are:
1. visual symptoms of retinal migraine are monocular
2. total, but temporary, monocular blindness may occur in retinal migraine.
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