![]() ![]() ![]() The only significant family history is her mum who has a history of migraine, without any visual aura.Īt presentation, the examination of the patient was completely normal: stable vital signs, no fever, no localizing cranial nerves or neurological signs. For her migraine, she takes a combination of paracetamol, diclofenac and prochloperazine as needed. The patient has never been on any regular drugs nor medications. Also, the attack has only happened in her left eye and never in the right eye, thus far. There were no sensory or motor disturbances associated with these attacks. ![]() There was one occasion when she developed vertiginous giddiness after the visual aura symptom. The headache may last anything between 30 minutes to several hours. By the time the headache comes on, the visual symptoms would have subsided. The visual symptom started first and is followed by the headache. Each episode would last about 15-20 minutes. She has observed this only in the last 6 months, with the attack coming on about once a month. There were no associated scotomas or sudden blindness and she was still able to identify normal images whilst experiencing the attack. At the same time, she noticed wave-like, flickering movements comprising of variety of colors (red, blue, green and yellow), commencing laterally and slowly spreading to the superior part of the visual field in her left eye. She described this as an appearance she had seen through a ‘kaleidoscope’. There was narrowing of the visual field in her left eye, whereby the area affected was the outer and lateral part of the visual field. A 54 year old lady with a history of migraine for many years (where she only has headaches), presented with new onset visual symptom. ![]()
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