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The visual aura rating scale as an outcome predictor for persistent visual aura without infarction
1Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Cephalalgia : an International Journal of Headache
|August 30, 2008
Summary
Persistent visual disturbances (VDs) without stroke are rare and difficult to treat. Higher Visual Aura Rating Scale (VARS) scores indicate a better prognosis for resolving these migraine-related symptoms.
Area of Science:
- Neurology
- Ophthalmology
Background:
- Persistent visual aura without infarction is a rare neurological condition.
- The underlying pathogenic mechanisms remain largely unknown.
- Treatment responses to prophylactic migraine medications vary significantly among patients.
Observation:
- A systematic analysis of 29 patients (23 from literature, 6 new cases) was conducted.
- Demographics, headache and visual symptom profiles, treatments, and outcomes were assessed.
- Visual disturbances were quantified using the Visual Aura Rating Scale (VARS).
Findings:
- Only 27.6% of patients achieved complete resolution of persistent visual disturbances.
- Complete resolution was associated with scotoma, unilateral/homonymous involvement, higher VARS scores, and shorter illness duration.
- No specific prophylactic agent demonstrated definite relevance for complete VD resolution.
Implications:
- The prognosis for persistent visual aura without infarction is generally poor.
- Higher VARS scores, indicative of more typical migraine visual aura, predict a better outcome.
- For patients with potential for resolution, improvement is likely to occur early in the disease course.
