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Arici C, Mergen B. Exercise-Induced Idiopathic Nasal Hemianopsia in a Young Professional Athlete. J Neuroophthalmol 2024:00041327-990000000-00612. [PMID: 38573772 DOI: 10.1097/wno.0000000000002137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- Ceyhun Arici
- Istanbul University-Cerrahpasa (CA), Cerrahpasa Medical Faculty, Department of Ophthalmology, Istanbul, Turkey; and Department of Ophthalmology (BM), University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
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2
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Takao M, Oishi A, Shimizu T, Kuwatsuka Y, Kitaoka T. Paracentral acute middle maculopathy in systemic sclerosis and subsequent branch retinal artery occlusion. Am J Ophthalmol Case Rep 2023; 32:101955. [PMID: 38020208 PMCID: PMC10663736 DOI: 10.1016/j.ajoc.2023.101955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/02/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose We report a case of systemic sclerosis-associated paracentral acute middle maculopathy (PAMM) in a young woman who subsequently developed branch retinal artery occlusion. Observations A 22-year-old woman presented with a paracentral scotoma. Optical coherence tomography (OCT) revealed bilateral paracentral acute middle maculopathy. Upon systemic examination, she was diagnosed with systemic sclerosis (SSc). She subsequently developed branch retinal artery occlusion despite vasodilator medications. After the prescription of aspirin, she did not experience a new event for one year. Conclusion and importance This case illustrates that SSc may affect the retinal vascular system and vision and cause PAMM. The optimal prophylaxis for patients with recurrent retinal events should be investigated in future studies.
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Affiliation(s)
- Miki Takao
- Department of Ophthalmology and Visual Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Ophthalmology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yutaka Kuwatsuka
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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3
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Naravane AV, Miller HV, Abel AS, Davies JB. Retinal Vasospasm-Induced Central Retinal Artery Occlusion and the Possible Role for Hyperbaric Oxygen Treatment. J Neuroophthalmol 2023:00041327-990000000-00501. [PMID: 37938116 DOI: 10.1097/wno.0000000000002028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Affiliation(s)
- Ameay V Naravane
- Department of Ophthalmology and Visual Neurosciences (AVN, HVM, ASA), University of Minnesota, Minneapolis, Minnesota; Department of Ophthalmology (ASA), Hennepin Healthcare, Minneapolis, Minnesota; and Retina Consultants of Minnesota (JBD), Minneapolis, Minnesota
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4
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Shi S, Wang D, Ren T, Wang W. Auditory Manifestations of Vestibular Migraine. Front Neurol 2022; 13:944001. [PMID: 35911900 PMCID: PMC9334870 DOI: 10.3389/fneur.2022.944001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/17/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives To investigate the auditory features of patients with vestibular migraine (VM) and to analyze the possible relevant factors of hearing loss. Methods A total of 166 patients with VM were enrolled. Demographic variables, age of onset, disease course, distribution of vestibular attacks, characteristics of hearing loss, and the coexistence of related disorders, such as visual aura, familial history, motion sickness, nausea, headache, photophobia, otalgia, tinnitus, aural fullness, and phonophobia, were analyzed and compared. Results Patients with VM can manifest otalgia (8.4%), tinnitus (51.8%), aural fullness (41%), and phonophobia (31.9%). Of 166 patients, the prevalence of VMw was 21.1% (n = 35). Patients with VMw mainly manifested mild and easily reversible low-frequency hearing loss. The proportions of tinnitus and aural fullness were significantly larger in patients with VMw than that in patients with VMo (P < 0.05). The duration of vestibular symptoms was significantly shorter in patients with VMw (P < 0.05). However, the age of onset, disease course, gender, frequency of vestibular attacks, the coexistence of visual aura, familial history, motion sickness, nausea, headache, photophobia, otalgia, and phonophobia had no significant difference between the two groups. Conclusion Auditory symptoms were common in patients with VM. The hearing loss of VM was characterized by a mild and easily reversible low-frequency hearing loss, accompanied by higher proportions of tinnitus and aural fullness, and a shorter duration of vestibular symptoms compared with patients with VMo.
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Affiliation(s)
- Suming Shi
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Dan Wang
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Tongli Ren
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Wuqing Wang
- ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
- *Correspondence: Wuqing Wang
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5
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Phatak S, Jaison J, Soman M, Mohan A, Nair RU. Retinal vasospastic phenomenon in a known case of systemic lupus erythematosus. Indian J Ophthalmol 2020; 68:2575-2577. [PMID: 33120697 PMCID: PMC7774229 DOI: 10.4103/ijo.ijo_161_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Retinal vasospasm was visualized in a young female; a known case of systemic lupus erythematosus (SLE) retinopathy with unaffected vision. The fundus fluorescein angiogram showed a cyclical filling and emptying of the retinal vessels which was suggestive of vasospasm and a retinal Raynaud's-like phenomenon with no obvious perfusion deficit. There was retinal thinning involving the superficial layers that was seen on optical coherence tomography (OCT), capillary fill voids on OCT angiography, and retinal surface undulations seen on multicolor imaging. All imaging was performed on Spectralis (Heidelberg, Germany).
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Affiliation(s)
- Sumita Phatak
- Department of Retina and Vitreous, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India
| | - Jilna Jaison
- Department of Retina and Vitreous, Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala, India
| | - Manoj Soman
- Department of Retina and Vitreous, Chaithanya Eye Hospital and Research Institute; CITE (Research), Trivandrum, Kerala, India
| | - Ashwin Mohan
- Department of Retina and Vitreous, Chaithanya Eye Hospital and Research Institute; CITE (Research), Trivandrum, Kerala, India
| | - R Unnikrishnan Nair
- Department of Retina and Vitreous, Chaithanya Eye Hospital and Research Institute; CITE (Research), Trivandrum, Kerala, India
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Yamanaka G, Go S, Morichi S, Takeshita M, Morishita N, Suzuki S, Tomoko T, Kasuga A, Daida A, Ishida Y, Oana S, Suganami Y, Nagao R, Kashiwagi Y, Kawashima H. Clinical Features and Burden Scores in Japanese Pediatric Migraines With Brainstem Aura, Hemiplegic Migraine, and Retinal Migraine. J Child Neurol 2020; 35:667-673. [PMID: 32476572 DOI: 10.1177/0883073820927840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Migraines are a broad spectrum of disorders classified by the type of aura with some requiring attentive treatment. Vasoconstrictors, including triptans, should be avoided in the acute phase of migraines with brainstem aura, in hemiplegic migraine, and in retinal migraine. This study investigated the characteristics and burden of these migraines. METHODS Medical charts of 278 Japanese pediatric patients with migraines were retrospectively reviewed. Migraine burden of migraines with brainstem aura, hemiplegic migraines, and retinal migraine was assessed using the Headache Impact Test-6™ (HIT-6) and the Pediatric Migraine Disability Assessment scale (PedMIDAS). RESULTS Of 278 patients screened, 12 (4.3%) patients with migraines with brainstem aura (n = 5), hemiplegic migraines (n = 2), and retinal migraine (n = 5) were enrolled in the study. All patients had migraine with/without typical aura, whereas some patients had coexisting migraine with another type of headache (chronic tension-type headache in 3 patients, and 1 each with frequent episodic tension-type headache, headache owing to medication overuse, and chronic migraine). Migraines with brainstem aura, hemiplegic migraines, and retinal migraine patients with coexisting headaches had higher HIT-6 or PedMIDAS scores, whereas migraines with brainstem aura, hemiplegic migraines, and retinal migraine patients without coexisting headache did not show high HIT-6 or PedMIDAS scores. CONCLUSION All migraines with brainstem aura, hemiplegic migraines, and retinal migraine patients experienced migraine with or without typical aura, and some patients having other coexisting headaches also had high PedMIDAS and HIT-6 scores. PedMIDAS and HIT-6 should not be considered diagnostic indicators of migraines with brainstem aura, hemiplegic migraines, or retinal migraine. In clinical practice for headaches in children, careful history taking and proactive assessment of the aura are needed for accurate diagnosis of migraines with brainstem aura, hemiplegic migraines, and retinal migraine.
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Affiliation(s)
- Gaku Yamanaka
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Soken Go
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Shinichiro Morichi
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Mika Takeshita
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Natsumi Morishita
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Shinji Suzuki
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Takamatsu Tomoko
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Akiko Kasuga
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Atsuro Daida
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yu Ishida
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Shingo Oana
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yusuke Suganami
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Ryuhei Nagao
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yasuyo Kashiwagi
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
| | - Hisashi Kawashima
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan
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Xin Y, Fu J, Xie L, Yang J, Ke G. Vestibular migraine with Wallenberg syndrome: a case report. BMC Neurol 2020; 20:211. [PMID: 32450818 PMCID: PMC7249651 DOI: 10.1186/s12883-020-01786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vestibular migraine, a kind of acute vestibular syndrome, leads to both migraines and vertigo symptoms in a single patient. The occurrence of vestibular migraine has shown an obvious increase in female groups based on age. Though it is recognized that migraines may cause ischemic lesions in some brain regions, the relationship between vestibular migraine and cerebral infarction has seldom been reported, especially with no known research reports about vestibular migraine with Wallenberg syndrome. Based on this, the connection of the two diseases needs to be the focus of more research. CASE PRESENTATION The patient, a 35-year-old lady, came to our department with severe vertigo and headaches for approximately two years. She suffered from migraines which attacked about twice yearly for nearly a decade. The diffusive weighted imaging showed a subacute infarction in the right lateral medullar. The clinical characteristics and MRI findings supported the diagnosis of vestibular migraine with Wallenberg syndrome. Along with the normal routine medication for vestibular migraine with Wallenberg syndrome, we also prescribed migraine therapy at the same time. In a 3-month follow-up, the patient had suffered only one vertigo attack and she reported that the migraines were less common and less intense than she was previously experiencing. CONCLUSIONS Due to the fact that vestibular migraine is one of the risk factors of cerebral ischemia, we need to pay more attention to this phenomenon. The current case suggests that both routine medication on ischemic stroke as well as treatment for migraines should be used concurrently in vestibular migraine with Wallenberg syndrome.
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Affiliation(s)
- Ying Xin
- Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China. .,Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou, 510260, China.
| | - Junyi Fu
- Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.,Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou, 510260, China
| | - Longchang Xie
- Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.,Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou, 510260, China
| | - Jie Yang
- Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.,Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou, 510260, China
| | - Guanhao Ke
- Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
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Mishulin A, Gandhi S, Apple D, Lin X, Hu J, Abrams GW. INDUCIBLE TRANSIENT CENTRAL RETINAL ARTERY VASOSPASM: A CASE REPORT. Retin Cases Brief Rep 2020; 14:178-180. [PMID: 28957956 DOI: 10.1097/icb.0000000000000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To report a case of inducible transient central retinal artery vasospasm with associated imaging. METHODS Observational case report. RESULTS A 51-year-old man presented for outpatient follow-up for recurrent inducible transient vision loss in his right eye. He experienced an episode during examination and was found to have central retinal artery vasospasm. Fundus photography and fluorescein angiography obtained during his vasospastic attack confirmed retinal arterial vasospasm. Treatment with a calcium-channel blocker (nifedipine) has been effective in preventing recurrent attacks. CONCLUSION Idiopathic primary vasospasm is a rare cause of transient vision loss that is difficult to confirm because of the transient nature. We obtained imaging showing the initiation and resolution of the vasospastic event. The patient was then successfully treated with a calcium-channel blocker.
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Affiliation(s)
- Aleksey Mishulin
- Department of Ophthalmology, Kresge Eye Institute, Wayne State University, Detroit, Michigan
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Abstract
Transient disturbances in neurologic function are disturbing features of migraine attacks. Aura types include binocular visual, hemi-sensory, language and unilateral motor symptoms. Because of the gradual spreading quality of visual and sensory symptoms, they were thought to arise from the cerebral cortex. Motor symptoms previously included as a type of migraine aura were reclassified as a component of hemiplegic migraine. ICHD-3 criteria of the International Headache Society, added brainstem aura and retinal aura as separate subtypes. The susceptibility to all types of aura is likely to be included by complex and perhaps epigenetic factors.
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Affiliation(s)
- Rod Foroozan
- Baylor College of Medicine, 6565 Fannin NC-205, Houston, TX 77030, USA.
| | - F Michael Cutrer
- Mayo Clinic, 200 First Street, Southwest, Rochester, MN 55905, USA
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11
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12
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Christakis PG, Alon R, Brent MH. Recurrent visual field defect associated with migraine resulting in a hemiretinal artery occlusion. Can J Ophthalmol 2018; 53:e92-e94. [PMID: 29784185 DOI: 10.1016/j.jcjo.2017.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 08/27/2017] [Accepted: 08/30/2017] [Indexed: 01/03/2023]
Affiliation(s)
| | - Roy Alon
- University of Toronto, Toronto, Ont
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13
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Cécité monoculaire transitoire : causes vasculaires et diagnostics différentiels. J Fr Ophtalmol 2018; 41:453-461. [DOI: 10.1016/j.jfo.2017.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/16/2017] [Indexed: 01/03/2023]
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Bidot S, Biotti D. Transient monocular blindness: Vascular causes and differential diagnoses. J Fr Ophtalmol 2018; 41:e129-e136. [PMID: 29673627 DOI: 10.1016/j.jfo.2017.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/16/2017] [Accepted: 12/15/2017] [Indexed: 01/03/2023]
Abstract
Transient monocular blindness is an acute episode of ischemic origin in which one eye has profound visual loss, followed by full recovery within one hour. Transient monocular blindness most often occurs in the setting of retinal ischemia secondary to carotid embolism, but other mechanisms have been reported, including thrombosis (most often in the setting of giant cell arteritis), hemodynamic disorders (secondary to severe carotid stenosis), or vasospasm. Transient monocular blindness is considered a transient ischemic attack originating in the carotid arteries, and must be managed the same as transient ischemic attack involving the brain, in order to prevent a subsequent stroke.
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Affiliation(s)
- S Bidot
- Fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France; Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
| | - D Biotti
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Service de neurologie B4, neurologie inflammatoire, neuro-ophtalmologie, bâtiment Pierre-Paul-Riquet, place du Dr-Baylac, TSA 40031, 31059 Toulouse cedex 9, France
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Jacqueline M. S. Winterkorn, MD, PhD: Master of Neuro-Empathology. J Neuroophthalmol 2017; 37:e6-e8. [DOI: 10.1097/wno.0000000000000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kissoon NR, Cutrer FM. Aura and Other Neurologic Dysfunction in or with Migraine. Headache 2017; 57:1179-1194. [DOI: 10.1111/head.13101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Narayan R. Kissoon
- Division of Headache, Department of Neurology; Mayo Clinic; Rochester MN USA
| | - Fred Michael Cutrer
- Division of Headache, Department of Neurology; Mayo Clinic; Rochester MN USA
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17
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Thrombolyic and Vasodilator Treatment in a Patient With Prolonged Retinal Ischemia. Neurologist 2017; 22:85-89. [PMID: 28471897 DOI: 10.1097/nrl.0000000000000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vasospastic transient monocular vision loss associated with systemic lupus erythematosus and antiphospholipid syndrome is typically short lasting and responsive to vasodilators. Virchow's triad of endothelial dysfunction, arterial stasis, and a hypercoagulable state are factors in systemic lupus erythematosus/antiphospholipid syndrome that may potentially contribute to prolonged retinal hypoperfusion and central retinal artery occlusion. Consequently, rapid intervention to address all components of Virchow's triad may increase the probability of a good outcome. Time of retinal viability should guide the management strategy. We report a systemic lupus erythematosus/antiphospholipid syndrome patient with prolonged monocular blindness coinciding with retinal arterial narrowing and rouleaux formation who responded favorably to sequential use of vasodilators and intravenous thrombolysis, addressing each component of Virchow's triad.
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Migraine and benign paroxysmal positional vertigo: a single-institution review. The Journal of Laryngology & Otology 2017; 131:508-513. [DOI: 10.1017/s0022215117000536] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Benign paroxysmal positional vertigo and migraine-associated dizziness are common. The prevalence of benign paroxysmal positional vertigo seems to be higher in patients with migraine-associated dizziness than in those without migraine.Methods:A database of 508 patients seen at the primary author's balance clinic was analysed to determine the prevalence of migraine, as defined by International Headache Society criteria, in patients with benign paroxysmal positional vertigo.Results:The percentage of patients with dizziness or vertigo who met criteria for migraine was 33.7 per cent, with a prevalence of benign paroxysmal positional vertigo of 42.3 per cent. When excluding patients with migrainous vertigo, patients with migraine frequently had benign paroxysmal positional vertigo (66.7 per centvs55.8 per cent), although this finding was not statistically significant.Conclusion:The results for the entire sample suggest that, after excluding patients with migrainous vertigo, patients with migraine seem more likely to have benign paroxysmal positional vertigo; however, this association was not significant, probably because of the small sample size.
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Vodopivec I, Cestari DM, Rizzo JF. Management of Transient Monocular Vision Loss and Retinal Artery Occlusions. Semin Ophthalmol 2016; 32:125-133. [DOI: 10.1080/08820538.2016.1228417] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ivana Vodopivec
- Massachusetts Eye and Ear Infirmary, Neuro-Ophthalmology Service, Boston, MA, USA
| | - Dean M. Cestari
- Massachusetts Eye and Ear Infirmary, Neuro-Ophthalmology Service, Boston, MA, USA
| | - Joseph F. Rizzo
- Massachusetts Eye and Ear Infirmary, Neuro-Ophthalmology Service, Boston, MA, USA
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Ophthalmological Assessment of OCT and Electrophysiological Changes in Migraine Patients. J Clin Neurophysiol 2016; 33:431-442. [PMID: 26840983 DOI: 10.1097/wnp.0000000000000256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A cross-sectional study to investigate the morphological and functional changes of the visual pathway taking place in patients with migraine. METHODS Fifteen patients (14 female, 1 male) diagnosed with migraine with aura and 23 patients (21 female, 2 male) diagnosed with migraine without aura were compared with 20 healthy volunteers (18 female, 2 male). All the participants underwent optical coherence tomography scan, electroretinogram (ERG), visual evoked potentials, and multifocal electroretinogram (mf-ERG) recording. RESULTS Assessing ERG recordings, no significant differences in mean N1-P1 amplitudes were measured among the groups. The mean visual evoked potentials N80-P100 amplitudes were not significantly different among the three groups (one way analysis of variance: P = 0.075, F = 2.718). No significant difference was found in P100 latency times among groups. The mean retinal response density of mf-ERG in ring 1 was higher in healthy individuals compared with migraineurs, with statistical significance (Kruskal-Wallis analysis of variance and Dunn multiple comparisons test; P < 0.001, mean rank difference = -24.857 and P < 0.001, mean rank difference = -20.9, for migraine with aura-control and migraine without aura-control comparisons, respectively). In migraine with aura subjects, retinal nerve fiber layer thickness in superior and inferior quadrants was significantly decreased compared with healthy individuals, whereas in migraine without aura group, only the superior quadrant was significantly thinner compared with the control group. CONCLUSIONS Retinal response density in mfERG of all migraineurs was significantly lessened compared with healthy individuals. There was no significant difference in visual evoked potentials N80-P100 amplitudes or P100 latencies among the groups. Moreover, retinal nerve fiber layer thinning observed in patients with migraine compared with control subjects, appeared statistically significant in some quadrants. The authors may be able to defend the retinal blood flow decrease theory in migraine. The results also indicate that several levels of the visual pathway seem to be affected in migraineurs.
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Abstract
Retinal migraine is usually characterized by attacks of fully reversible monocular visual loss associated with migraine headache. Herein we summarize the clinical features and prognosis of 46 patients (six new cases and 40 from the literature) with retinal migraine based upon the International Classification of Headache Disorders-2 (ICHD-2) criteria. In our review, retinal migraine is most common in women in the second to third decade of life. Contrary to ICHD-2 criteria, most have a history of migraine with aura. In the typical attack monocular visual features consist of partial or complete visual loss lasting <1 h, ipsilateral to the headache. Nearly half of reported cases with recurrent transient monocular visual loss subsequently experienced permanent monocular visual loss. Although the ICHD-2 diagnostic criteria for retinal migraine require reversible visual loss, our findings suggest that irreversible visual loss is part of the retinal migraine spectrum, perhaps representing an ocular form of migrainous infarction. Based on this observation, the authors recommend migraine prophylactic treatment in an attempt to prevent permanent visual loss, even if attacks are infrequent. We also propose a revision to the ICHD-2 diagnostic criteria for retinal migraine.
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Affiliation(s)
- B M Grosberg
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, NY, USA.
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Jogi V, Mehta S, Gupta A, Singh P, Lal V. More clinical observations on migraine associated with monocular visual symptoms in an Indian population. Ann Indian Acad Neurol 2016; 19:63-8. [PMID: 27011631 PMCID: PMC4782555 DOI: 10.4103/0972-2327.168628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Context: Retinal migraine (RM) is considered as one of the rare causes of transient monocular visual loss (TMVL) and has not been studied in Indian population. Objectives: The study aims to analyze the clinical and investigational profile of patients with RM. Materials and Methods: This is an observational prospective analysis of 12 cases of TMVL fulfilling the International Classification of Headache Disorders-2nd edition (ICHD-II) criteria of RM examined in Neurology and Ophthalmology Outpatient Department (OPD) of Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh from July 2011 to October 2012. Results: Most patients presented in 3rd and 4th decade with equal sex distribution. Seventy-five percent had antecedent migraine without aura (MoA) and 25% had migraine with Aura (MA). Headache was ipsilateral to visual symptoms in 67% and bilateral in 33%. TMVL preceded headache onset in 58% and occurred during headache episode in 42%. Visual symptoms were predominantly negative except in one patient who had positive followed by negative symptoms. Duration of visual symptoms was variable ranging from 30 s to 45 min. None of the patient had permanent monocular vision loss. Three patients had episodes of TMVL without headache in addition to the symptom constellation defining RM. Most of the tests done to rule out alternative causes were normal. Magnetic resonance imaging (MRI) brain showed nonspecific white matter changes in one patient. Visual-evoked potential (VEP) showed prolonged P100 latencies in two cases. Patent foramen ovale was detected in one patient. Conclusions: RM is a definite subtype of migraine and should remain in the ICHD classification. It should be kept as one of the differential diagnosis of transient monocular vision loss. We propose existence of “acephalgic RM” which may respond to migraine prophylaxis.
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Affiliation(s)
- Vishal Jogi
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sahil Mehta
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amod Gupta
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Paramjeet Singh
- Department of Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Lal
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Vasospastic Amaurosis Fugax Diagnosed by Cerebral Angiography. J Stroke Cerebrovasc Dis 2015; 24:e323-5. [PMID: 26283520 DOI: 10.1016/j.jstrokecerebrovasdis.2015.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/02/2015] [Accepted: 07/16/2015] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED We report a case of recurrent monocular blindness presumed to be caused by vasospasm, demonstrated by digital subtraction angiography. CASE REPORT A 65-year-old man presented with recurrent visual loss in the left eye for 2 years. He had histories of hypertension, cigarette smoking, and May-Thurner syndrome. The symptom occurred variably from twice a day to once a week and usually lasted for 5 minutes. Brain magnetic resonance imaging, magnetic resonance angiography, and ophthalmologic evaluation did not reveal any abnormality. Cerebral digital subtraction angiography was performed. On the left internal carotid angiogram, vasospasm occurred in the cervical portion of the left internal carotid artery and, subsequently, the blood flow to the left ophthalmic artery diminished. This phenomenon was reproducible and, in the absence of vasospasm, the ophthalmic artery was well visualized with no steno-occlusive lesion. Examination of the carotid duplex showed diffuse luminal narrowing and increased flow velocities in the left cervical internal carotid artery without atherosclerotic plaque. Treatment was started with nimodipine, which markedly reduced the attacks. CONCLUSION We assumed that vasomotor instability, which made the vessels vulnerable to spasm, may have caused a recurrent ocular symptom in our patient.
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Lawlor M, Perry R, Hunt BJ, Plant GT. Strokes and vision: The management of ischemic arterial disease affecting the retina and occipital lobe. Surv Ophthalmol 2015; 60:296-309. [DOI: 10.1016/j.survophthal.2014.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 12/10/2014] [Accepted: 12/16/2014] [Indexed: 11/16/2022]
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Choi SY, Moon HJ, Huh YE, Yang HK, Woo SJ, Jung C, Kwon OK, Kim JS. Recurrent transient monocular blindness from stenotic central retinal artery. J Clin Neurosci 2013; 20:1603-5. [PMID: 23830588 DOI: 10.1016/j.jocn.2012.09.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 09/23/2012] [Indexed: 11/16/2022]
Abstract
Transient monocular blindness (TMB) is caused by a temporary reduction of blood flow to the retina or optic nerve. Even though embolism from the ipsilateral carotid artery has been considered the main mechanism of TMB, the vascular pathology remains unknown in many patients. A 42-year-old man presented with recurrent transient visual loss in the left eye for 2 months. The attacks tended to develop more frequently when his head was bent down. Fluorescence angiography during an attack revealed hypoperfusion of the left central retinal artery (CRA) and cerebral angiography documented a focal isolated stenosis of the CRA at the origin. Aspirin and nimodipine reduced the attacks markedly. Stenosis of the CRA may be a cause of TMB. Intermittent vasospasm in addition to static hypoperfusion may have caused TMB in our patient with isolated CRA stenosis.
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Affiliation(s)
- Seo Young Choi
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
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Petzold A, Islam N, Plant GT. Patterns of non-embolic transient monocular visual field loss. J Neurol 2013; 260:1889-900. [PMID: 23564298 DOI: 10.1007/s00415-013-6902-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 03/21/2013] [Indexed: 10/27/2022]
Abstract
The aim of this study was to systematically describe the semiology of non-embolic transient monocular visual field loss (neTMVL). We conducted a retrospective case note analysis of patients from Moorfields Eye Hospital (1995-2007). The variables analysed were age, age of onset, gender, past medical history or family history of migraine, eye affected, onset, duration and offset, perception (pattern, positive and negative symptoms), associated headache and autonomic symptoms, attack frequency, and treatment response to nifedipine. We identified 77 patients (28 male and 49 female). Mean age of onset was 37 years (range 14-77 years). The neTMVL was limited to the right eye in 36 % to the left in 47 % and occurred independently in either eye in 5 % of cases. A past medical history of migraine was present in 12 % and a family history in 8 %. Headache followed neTMVL in 14 % and was associated with autonomic features in 3 %. The neTMB was perceived as grey in 35 %, white in 21 %, black in 16 % and as phosphenes in 9 %. Most frequently neTMVL was patchy 20 %. Recovery of vision frequently resembled attack onset in reverse. In 3 patients without associated headache the loss of vision was permanent. Treatment with nifedipine was initiated in 13 patients with an attack frequency of more than one per week and reduced the attack frequency in all. In conclusion, this large series of patients with neTMVL permits classification into five types of reversible visual field loss (grey, white, black, phosphenes, patchy). Treatment response to nifidipine suggests some attacks to be caused by vasospasm.
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28
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Petzold A, Islam N, Hu HH, Plant GT. Embolic and Nonembolic Transient Monocular Visual Field Loss: A Clinicopathologic Review. Surv Ophthalmol 2013; 58:42-62. [DOI: 10.1016/j.survophthal.2012.02.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 02/01/2012] [Accepted: 02/07/2012] [Indexed: 12/01/2022]
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Recurrent Amaurosis Fugax in a Patient after Stanford Type A Dissection Depending on Blood Pressure and Haemoglobin Level. Case Rep Vasc Med 2012. [PMID: 23198268 PMCID: PMC3502825 DOI: 10.1155/2012/254204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose. A transient painless monocular visual loss due to a decrease in retinal circulation—also known as “amaurosis fugax”—often precedes acute territorial cerebral ischaemia. The case we present underlines the importance of a comprehensive diagnostic workup in patients with amaurosis fugax. Case Report. A 44-year-old man who had suffered from a dissection of the ascending aorta (Stanford Type A) five months ago presented with recurrent monocular vision problems. Episodes with sectional vision loss mainly occurred in combination with low blood pressure levels. Furthermore, the haemoglobin level was chronically low (Hb 9.7 mg/dL), and the patient was by mistake on a simultaneous therapy with phenprocoumon and unfractionated heparin. Carotid artery duplex scanning revealed a high-grade stenosis of the proximal right common carotid artery. MR imaging corroborated hypoperfusion in brain area corresponding to the right MCA. Conclusion. Our patient is an example in whom transient retinal ischaemic attacks may originate from haemodynamic reasons.
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Moore D, Harris A, Wudunn D, Kheradiya N, Siesky B. Dysfunctional regulation of ocular blood flow: A risk factor for glaucoma? Clin Ophthalmol 2011; 2:849-61. [PMID: 19668439 PMCID: PMC2699797 DOI: 10.2147/opth.s2774] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Primary open angle glaucoma (OAG) is a multifactorial optic neuropathy characterized by progressive retinal ganglion cell death and associated visual field loss. OAG is an emerging disease with increasing costs and negative outcomes, yet its fundamental pathophysiology remains largely undetermined. A major treatable risk factor for glaucoma is elevated intraocular pressure (IOP). Despite the medical lowering of IOP, however, some glaucoma patients continue to experience disease progression and subsequent irreversible vision loss. The scientific community continues to accrue evidence suggesting that alterations in ocular blood flow play a prominent role in OAG disease processes. This article develops the thesis that dysfunctional regulation of ocular blood flow may contribute to glaucomatous optic neuropathy. Evidence suggests that impaired vascular autoregulation renders the optic nerve head susceptible to decreases in ocular perfusion pressure, increases in IOP, and/or increased local metabolic demands. Ischemic damage, which likely contributes to further impairment in autoregulation, results in changes to the optic nerve head consistent with glaucoma. Included in this review are discussions of conditions thought to contribute to vascular regulatory dysfunction in OAG, including atherosclerosis, vasospasm, and endothelial dysfunction.
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Affiliation(s)
- Danny Moore
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
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31
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Mohr J, Mast H. Carotid Artery Disease. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Pérdida transitoria de la visión. REVISTA MÉDICA CLÍNICA LAS CONDES 2010. [DOI: 10.1016/s0716-8640(10)70623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Friedman DI, Frishberg B. Neuro-ophthalmology and its contribution to headaches: a case-based approach. Expert Rev Neurother 2010; 10:1467-78. [DOI: 10.1586/ern.10.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
Transient monocular visual loss is an important clinical complaint and has a number of causes, of which the most common is retinal ischemia. A practical approach is to perform a careful examination to determine whether there are any eye abnormalities that can explain the visual loss. Despite the transient nature of the symptom, there may be clues to the diagnosis on the examination even after the visual loss has recovered.
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Affiliation(s)
- Rehan Ahmed
- Cullen Eye Institute, Baylor College of Medicine, 7200B Cambridge Street, Houston, TX 77030, USA
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35
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Abstract
Migraine-associated vertigo has become a well-recognized disease entity diagnosed based on a clinical history of recurrent vertigo attacks unexplained by other central or peripheral otologic abnormalities, which occurs in the patient with a history of migraine headaches. There is no international agreement on what spectrum of symptoms should be covered under this diagnosis, or what terminology should be used. The headaches and vestibular symptoms of migraine-associated vertigo may not be temporally associated, which often obscures the association. Diagnostic tests usually show nonspecific abnormalities that are also seen in patients with migraine who do not experience vestibular symptoms. Management generally follows the recommended treatment of migraine headaches, and includes dietary and lifestyle modifications and medical treatment with beta blockers, calcium channel blockers, and tricyclic amines. Small case series show that acetazolamide and lamotrigine appear to be more effective for the vertigo attacks than headaches. Vestibular rehabilitation has also been shown to be helpful in several studies. In this review, the epidemiologic and clinical features of the disorder, as well as the current state of knowledge on pathophysiology, diagnostic testing, and treatment are described.
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Affiliation(s)
- Yoon-Hee Cha
- Department of Neurology, University of California Los Angeles, Los Angeles, California, USA.
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Headache, facial pain, and disorders of facial sensation. Neuroophthalmology 2010. [DOI: 10.1016/b978-1-4160-2311-1.00019-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Liu GT, Volpe NJ, Galetta SL. Transient visual loss. Neuroophthalmology 2010. [DOI: 10.1016/b978-1-4160-2311-1.00010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Jo YJ, Yun YJ, Kwag JY, Kim JY. Valsalva Maneuver-induced Amaurosis Fugax. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.5.779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Young Joon Jo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
- Institute for Medical Sciences, Chungnam National University Research, Daejeon, Korea
| | - Yong Jun Yun
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Joo Young Kwag
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jung Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
- Institute for Medical Sciences, Chungnam National University Research, Daejeon, Korea
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Cochard-Marianowski C, Lamirel C, Biousse V. [Vascular transient monocular visual loss]. J Fr Ophtalmol 2009; 32:765-9. [PMID: 19939503 PMCID: PMC3711488 DOI: 10.1016/j.jfo.2009.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Accepted: 10/13/2009] [Indexed: 11/15/2022]
Abstract
Diagnosis and management of transient monocular visual loss is an emergency. Ocular conditions causing transient visual loss are routinely managed by ophthalmologists. Vascular transient monocular visual loss may result from emboli, hypoperfusion, vasospasm, or venous congestion. Evaluation focuses on the carotid arteries, ophthalmic arteries, the aortic arch, the heart, and rarely hypercoagulable states. Secondary prevention of ischemic events is essential in order to prevent permanent visual loss as well as cerebral ischemic and cardiovascular death. Aggressive treatment of vascular risk factors is usually associated with antiplatelet agents. Anticoagulant and carotid surgery are only rarely required after vascular transient monocular visual loss.
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Aleci C, Liboni W. Perceptive aspects of visual aura. Neurol Sci 2009; 30:447-52. [PMID: 19779857 DOI: 10.1007/s10072-009-0137-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 08/28/2009] [Indexed: 10/20/2022]
Abstract
Visual aura is the most common feature associated with migraine, though it can occur separately. In both cases it often represents a dramatic event, especially for patients who experience it for the first time. Besides, its subjective characteristics may illuminate on the functional architecture of the visual cortex. Repetitive events of migraine and visual aura have been suggested to affect the visual system in the long run, both on the cortical and precortical level. In effect, objective investigation of visual functions in patients support the idea that a selective damage does occur, so that more attention to visual examination seems to be justified. In this paper, subjective and psychophysical aspects of visual aura are examined, lastly highlighting and discussing the interesting correlations found between this condition and normal-tension glaucoma.
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Affiliation(s)
- Carlo Aleci
- Ophthalmology Department, Gradenigo Hospital, Cso R Margherita 8, 10153 Turin, Italy.
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41
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Safran AB, Boschi AM. Light-induced ocular pain and visual obscurations in severe vasospastic disease. Neuroophthalmology 2009. [DOI: 10.3109/01658109709044653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mora R, Dellepiane M, Barettini L, Crippa B, Salami A. Electronystagmography in migraine equivalent syndrome. Otolaryngol Head Neck Surg 2009; 140:566-72. [DOI: 10.1016/j.otohns.2008.12.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Revised: 12/09/2008] [Accepted: 12/09/2008] [Indexed: 11/27/2022]
Abstract
Objectives: The aim of the study was to determine the efficacy of electronystagmography testing in the diagnosis of vertigo in children with migraine equivalent syndrome. Study Design: The investigation included 20 children with “migraine equivalent syndrome” (group A), characterized by benign paroxysmal vertigo of childhood. As a control group, 50 healthy children were identified. Subjects and Methods: All the subjects underwent rotatory vestibular stimulation by stop test, optokinetic stimulation, and simultaneous postrotatory vestibular and optokinetic stimulations (VVOR). Results: For the analysis of the results, we considered nystagmus mean gain and direction of visual-vestibular-ocular-reflex (VVOR) nystagmus. In group A, all the children presented a VVOR nystagmus homodirectional to vestibular-ocular reflex (VOR). In the control group, all the subjects presented a VVOR nystagmus homodirectional to optokinetic nystagmus (OKN). Conclusion: In the healthy patients, VVOR nystagmus is always homodirectional to OKN and indicates the optokinetic system prevalence on VOR. The presence of a VVOR nystagmus homodirectional to VOR indicates the absence of the optokinetic system prevalence due to a central nervous system (CNS) modification and highlights a CNS disease. Our data highlight a possible correlation between CNS disorders and migraine equivalent syndrome.
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Affiliation(s)
- Renzo Mora
- ENT Department, University of Genoa, Genoa, Italy
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45
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Cecità monoculare transitoria. Neurologia 2009. [DOI: 10.1016/s1634-7072(09)70508-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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46
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47
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Weinstein JM. Headache and Facial Pain. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00176-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Affiliation(s)
- Matthew J Thurtell
- Department of Neurology, University Hospitals Case Medical Center, Cleveland, OH 44108, USA
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