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Visual alterations common before and during migraines.

LOS ANGELES -- Visual disturbances may be far more common among patients with migraines than previously believed, according to a study presented at the annual scientific meeting of the American Headache Society.

Dr. Abouch V. Krymchantowski and Dr. Marcus V. Adriano of the Headache Center of Rio de Janeiro prospectively queried 100 consecutive patients (90 women and 10 men) with migraine headaches about their visual symptoms, whether or not they believed their symptoms constituted an aura. The patients ranged in age from 17 to 73 (mean age, 36).

Migraine without aura was the most common diagnosis, seen in 74 patients. Another 10 had migraine with aura, while 16 had both types of headache.

Nearly half--44 of 100 patients--reported some visual alteration that occurred before or during migraine attacks, far higher than the roughly 10% of migraine patients considered to have visual auras. Symptoms included blurred vision in 31 patients, bright spots in 15, zigzag lines in 7, dark spots in 5, diplopia in 4, transient blindness in 3, and hemianopsia in 2. Some patients reported more than one visual symptom, and 19 said their visual symptoms occurred in conjunction with every migraine.

Although 17 patients said they had sought consultations with ophthalmologists concerning their vision problems, only two ophthalmologists correctly linked the symptoms to migraines, Dr. Krymchantowski reported. Blurred vision, the most common visual disturbance experienced by patients in the study, may be commonly overlooked. "We are in doubt that patients would report it if not asked," he said.

An audience member noted that some of his patients report blurred vision that lasts days or even weeks in conjunction with migraine headaches.

Dr. Krymchantowski suggested that visual auras may be too narrowly defined in current headache guidelines.


Los Angeles Bureau

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Title Annotation:Clinical Rounds; risk factors of migraine
Author:Bates, Betsy
Publication:Family Practice News
Article Type:Brief article
Geographic Code:1U9CA
Date:Sep 1, 2006
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