Retinal Migraine - The Basics

·         At least one of these characteristics:

1.      nausea and/or vomiting

2.      photophobia (increased sensitivity to light) and phonophobia (increased sensitivity to sound) 

The primary differentiating factors between retinal Migraine and Migraine with aura are:

1. The visual symptoms of retinal Migraine are monocular.
2. Total, but temporary, monocular blindness may occur in retinal Migraine.
    

Diagnosing Retinal Migraine:

There are no diagnostic tests to confirm retinal Migraine. Diagnosis is accomplished by reviewing the patient's personal and family medical history, studying their symptoms, and conducting an examination. Retinal Migraine is then diagnosed by ruling out other causes for the symptoms. With retinal Migraine, it is essential that other causes of transient blindness be fully investigated and ruled out. 

Retinal Migraine Treatment:

For infrequent attacks, medications used for other forms of Migraine are often employed to relieve the other symptoms. These medications can include NSAIDs, antinausea medications, Midrin, ergotamines the triptans. The choice of medications is somewhat affected by the age of the patient. When Migraines are frequent, the same preventive therapies used for other Migraines can be explored.

Repeated attacks of monocular visual disturbance, including scintillations, scotomata or blindness, associated with Migraine headache.

The diagnostic criteria for retinal Migraine under ICHD-II are:

A.     At least 2 attacks fulfilling criteria B and C

B.      Fully reversible monocular positive and/or negative visual phenomena (e.g., scintillations, scotoma or blindness) confirmed by examination during an attack or (after proper instruction) by the patient’s drawing of a monocular field defect during an attack

B.

C.     Headache fulfilling criteria B–D for Migraine without aura begins during the visual symptoms or follows them within 60 minutes

D.     Normal ophthalmological examination between attacks