Typical aura without headache: a case report and review of the literature

Typical aura without headache (TAWH), which has been rarely reported both at home and abroad, is a rare type of migraine with aura.

This is a report on a 64-year-old Chinese migraineur who has had recurrent typical visual aura without headache attacks for more than 30 years, and has been misdiagnosed as having had transient ischemic attacks (TIA) many times. He mainly experienced episodes of 'homonymous blurred vision' or photopsia, which presented as different shapes located at the side or above his visual field, for example, patchy, cord-like, zigzag, curtain-like or irregular shapes. The shape was inconsistent during each attack, however, the color was mainly gray or light blue. The visual symptoms gradually disappeared in about 30 minutes. Our patient has never suffered a headache attack during or after the visual aura. Normal results were observed in his neurological and eye examinations, complete blood test, electroencephalogram and neuroimaging examination.

TAWH is an uncommon phenomenon of migraine. Migraine with visual aura mainly presents positive and dynamic symptoms. It has a benign course and can be diagnosed after exclusion of other organic diseases such as TIA and epilepsy.