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Other causes of persisting perception disorder than migraine Other causes of persisting perception disorder than migraine
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Transitory aura symptoms

Persistent aura symptoms

Author: Klaus Podoll, Markus Dahlem, Sofia Greene 21. February 2007
Edited by: Klaus Podoll, Markus Dahlem, Sofia Greene

Other causes of persisting perception disorder than migraine

Jerri Magni and Rick London, I keep having these flashbacks, 2000. © 2000 Londons Times Cartoons (see here)

Of course, there may be other causes of "visual snow" or other chronic visual disturbances than migraine. The current ICHD-II criteria of persistent aura without infarction require that persisting visual symptoms must "Not [be] attributed to another disorder" (see here), so that thorough taking of the history, ophthalmologic, neurological and psychiatric examinations as well as MRI investigation (to exclude migrainous infarction or leukoencephalopathy among other things, see here) are mandatory in the diagnostic workup of all patients presenting with the complaint of such chronic visual disturbances. Contrary to many patients' expectations, a subtle history taking (rather than the administration of laboratory or other medical tests) is the medical investigation of greatest importance to discern the major differential diagnoses in diagnostic-work up. Beyond sufferers from persistent aura without infarction, the participants in Sofia Greene's internet survey included subjects with a variety of categories of diagnoses, as shown on the webpages provided by the links at the left margin.

Diagnostic work-up of persistent perception disorder/persistent aura without infarction

Obligatory tests:

Ophthalmologic examination
Neurological examination
Psychiatric examination
Thorough headache history and family history
Thorough drug history (including illegal drugs, especially hallucinogens: LSD, Ecstasy, mushrooms, other?)
CAT or MRI of head

Facultative tests:

EEG
Evoked potentials
Routine blood work
Lumbar puncture (spinal tap)

Unnecessary for individual diagnostic purposes:

SPECT
PET
fMRI
qEEG

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Pre-publication research on migraine with aura