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Scintillating scotoma is a common visual aura that was first described by 19th-century physician Hubert Airy (1838–1903). Originating from the brain, it may precede a migraine headache , but can also occur acephalgically (without headache), also known as visual migraine or migraine aura. [ 4 ]
Scintillating scotoma is a common visual aura in migraine. [4] Less common, but important because they are sometimes reversible or curable by surgery, are scotomata due to tumors such as those arising from the pituitary gland, which may compress the optic nerve or interfere with its blood supply. Rarely, scotomata are bilateral.
Photopsia; This is an approximation of the zig-zag visual of a scintillating scotoma as a migraine aura. It moves and vibrates, expanding and slowly fading away over the course of about 20 minutes.
Artist's depiction of scintillating scotoma Example of a scintillating scotoma aura with each dot or line flickering Example of scintillating scotoma showing an obscured/distorted area bordered with colors. An aura sensation can include one or a combination of the following:
The aura phase of migraine can occur with or without a headache. Ocular or retinal migraines happen in the eye, so only affect the vision in that eye, while visual migraines occur in the brain, so affect the vision in both eyes together. Visual migraines result from cortical spreading depression and are also commonly termed scintillating scotoma.
The scintillating scotoma of migraine in humans may be related to the neurophysiologic phenomenon termed the spreading depression of Leão. [13] Increased extracellular potassium ion concentration and excitatory glutamate contribute to the initiation and propagation of cortical spreading depression, which is the underlying cause of migraine ...
Illustration from 1870, by Hubert Airy, is one of the first pictures of a migraine aura. Hubert Airy (June 14, 1838 – June 1, 1903) was an English physician [1] who was the pioneer in the study of a migraine. [2]
In other clinical sub-forms of migraine headache may be absent and the migraine aura may not take the typical form of the zigzagged fortification spectrum (scintillating scotoma), but manifests with a large variety of focal neurological symptoms. [25] Visual snow does not depend on the effect of psychotropic substances on the brain. [13]