![]() Furthermore, we did not consider articles exclusively relating to familial or sporadic hemiplegic migraine, basilar-type migraine, persistent auras or symptomatic (secondary) MA. We excluded studies focusing exclusively on the description of visual disturbances relative to high-tier areas (i.e. In addition, only articles in English were considered. We felt that 10 was a reasonable number, although this was an (expert) agreement and not based on scientific evidence. We put this cut-off as generally small case series typically focus on unusual case presentations and are not able to provide an externally valid spectrum of manifestations. Inclusion criteria were a minimum of 10 migraine patients included where the features of VASs were described. Moreover, we considered the bibliography of the International Classification of Headache Disorders, Third Edition (ICHD-3). The bibliographies of all included studies were also searched as well as literature that was known to be relevant by the authors. The search string was (((“migraine with aura”) OR “migraine aura”) AND visual ). We used the PubMed/MEDLINE database to identify published studies systematically investigating the clinical features of visual aura. The literature search was performed on June 1st 2018. Based on these data, we aimed to create a comprehensive list of the different types of EVSs including their respective frequency of occurrence. The aim of this article was to review all published studies providing systematic descriptions of VASs, with information on how frequently different EVSs are reported by MA patients. Improved clinical characterisation of MA will likely improve the diagnostic accuracy and identification of patient subgroups at risk of comorbidity. It is also often clinically challenging to differentiate MA from other conditions, particularly transient ischemic attacks and occipital epilepsy. MA is associated with an increased risk of ischemic stroke, atrial fibrillation, and patent foramen ovale. ![]() An accurate description of the clinical features, in combination with investigations such as neuroimaging, is necessary to provide a better understanding of the underlying mechanisms.Įven more importantly, there are serious clinical issues related to MA that call for improved characterisation of the individual features. While MA is likely caused by cortical spreading depression, a transient wave of neuronal depolarization of the cortex, there is currently no pathophysiological explanation for the marked heterogeneity of visual symptoms. Several studies have investigated the clinical features of VASs but so far there is no consensus regarding which different types of EVSs occur during MA and there is no agreement on the terminology that should be used to describe EVSs. Viana and colleagues previously observed that these visual phenomena could be effectively defined by subdividing the perceived visual scenarios into so-called elementary visual symptoms (EVS), such as zigzag lines, crescent shapes, and flickering lights. In clinical studies of VAS, patients have reported a plethora of different, often complex, visual disturbances. In addition to being the most common aura symptoms, VASs are also the most multifaceted. Visual aura symptoms (VASs) are by far the most common and occur in 98–99% of MAs, whereas disturbances of sensation and language occur in 36% and 10% of auras, respectively. Typical migraine aura (MA) symptoms are completely reversible visual, sensory, or language disturbances. Migraine with typical aura is a highly prevalent disorder as it affects 8% of the general population.
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