The aura is typically bilateral and simultaneous as opposed to retinal vasospasm (“retinal migraine”) which is unilateral.įIGURE 1. The visual aura is often unrelated to the side of head pain and can be heterogenous or pleomorphic. In contrast, visual aura may involve a flickering, scintillating, crescent-shaped, bright geometric figure in the visual hemifield with march and build up. It can be differentiated from photophobia in patients with trigeminal autonomic cephalalgias including hemicrania continua as those conditions more often present unilaterally, ipsilateral to the side of pain. Photophobia is almost always bilateral in patients with migraine. It may affect visual and color perception and induce visual perceptual distortions. Photophobia typically presents as light sensitivity, ocular discomfort, and/or headache exacerbation by light. The most common neuro-ophthalmologic symptoms are photophobia and visual aura. Migraine headaches can be episodic (occurring 15 days per month), and a number of prodromal or postdromal symptoms may also occur hours before or after a migraine headache occurs. They are typically 4-72 hours in duration and are often debilitating (see HIS criteria below). Less commonly, migraines may present bilaterally, with a moderate, constant pain. Migraine refers to a primary headache disorder commonly characterized by severe, unilateral (alternating hemicranias), throbbing pain with associated nausea, photophobia, phonophobia, and preceding aura. 2.4 Diagnostic Procedures & Laboratory Tests.
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