Retinal Migraine - The Basics

by Teri Robert, MyMigraineConnection Lead Expert

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Diagnosing Migraine

One of the difficulties encountered at times when discussing Migraines occurs when a Migraineur is given a diagnosis that isn't actually accurate in diagnostic terms, but is really a descriptive term. Such terms may be used fairly frequently, but they fall short of a diagnosis and may also be used differently from one doctor to another. That's one reason why most doctors diagnose based in the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II). A "standard" diagnosis also makes communications and transitions easier when patients need to consult other doctors or change doctors.

There are several terms that are sometimes used, supposedly as Migraine diagnoses, that involve visual symptoms. Most of them aren't actually standard Migraine diagnoses. Retinal Migraine, however, is an actual Migraine diagnosis. What becomes confusing about it is that it's sometimes misused, resulting in a misdiagnosis. The term "retinal Migraine" is often misused to mean any Migraine that involves any visual symptoms or a Migraine with visual symptoms but without the headache phase of the attack. 

Retinal Migraine Symptoms:

Retinal Migraine is Migraine where there are repeated attacks of visual disturbances preceding the headache phase of the Migraine attacks.

A retinal Migraine attack begins with monocular (in one eye) visual symptoms that can include:

  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. The headache 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 or causing avoidance of routine physical activity such as walking or climbing stairs

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