DISTURBANCES OF VISUAL PERCEPTION IN MIGRAINE

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Abstract
Similar symptoms in 8 patients with severe migraine are described in detail, both from a thorough exploration of the case history and as they were revealed by means of a simple experimental technique using monocular fixation. During migraine attacks the patients experienced diplopia, polyopia, waviness of linear components, distortion of contours, macropsia, micropsia, corona phenomenon, apparent movement of stationary objects, illusionary jerky movement of steadily moving objects, dimness of vision, and asthenopic scotomas. Many of these phenomena could appear and disappear in a cyclical fashion (pulsation phenomena). Concentric reduction of the visual fields, reduction in the discrimination of contrast, color changes, disturbances in the judgement of distances, and visual perseveration were also described. The patients reported similar visual disturbances during monocular fixation experiments carried out between migraine attacks. These occurred with a latency of between 2 and 10 seconds[long dash]during the attacks there was sometimes also latency, but this was apparently shorter. There were no alterations of consciousness or feeling tone during the experimental procedure nor, with the exception of a single psychotic episode in 1 patient, during the attacks of migraine in which the visual disturbances occurred. The pathogenesis of the neurological symptoms is briefly discussed. The theory that migraine may be due to a dysfunction of the vertebro-basilar arterial system is supported by evidence obtained from the study of the side-effects of catheter vertebral angiography.

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