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Retinal migraine reappraised.

B M Grosberg1, S Solomon, D I Friedman

  • 1Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, NY, USA. bgrosber@montefiore.org

Cephalalgia : an International Journal of Headache
|October 25, 2006
PubMed
Summary
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Retinal migraine can cause temporary vision loss but may lead to permanent impairment. Prophylactic treatment is recommended to prevent irreversible visual loss, even with infrequent attacks.

Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Retinal migraine is defined by reversible monocular vision loss with migraine headache.
  • The International Classification of Headache Disorders-2 (ICHD-2) criteria guide diagnosis.

Observation:

  • This review analyzed 46 cases of retinal migraine.
  • Retinal migraine predominantly affects women aged 20-30.
  • Most patients had a history of migraine with aura, contrary to ICHD-2 criteria.

Findings:

  • Attacks involve transient monocular visual loss (<1 hour), ipsilateral to headache.
  • Nearly 50% of patients with recurrent transient visual loss experienced permanent vision loss.
  • Irreversible vision loss suggests retinal migraine may encompass migrainous infarction.

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Implications:

  • Findings challenge current ICHD-2 diagnostic criteria for retinal migraine.
  • Prophylactic migraine treatment is advised to prevent permanent visual deficits.
  • A revision to the ICHD-2 criteria for retinal migraine is proposed.