Visual aura

Abstract

Visual aura is a combination of transient positive and negative visual phenomena that can be seen in migraine, epilepsy, and stroke. While the pathophysiology of the visual aura in migraine is widely accepted to be due to cortical spreading depression (CSD), the trigger for CSD in humans is not clear. Multiple studies have demonstrated an increased risk of stroke in patients who have migraine with aura, especially women under age 45, and an increased incidence of patent foramen ovale (PFO). Despite distinct differences in pathophysiology, migraine with and without aura are largely treated the same. There is one FDA-approved treatment specifically for the acute phase of migraine with aura: single-pulse transcranial magnetic stimulation (sTMS). Other studies looking at the treatment of migraine with aura are aimed at N-methyl-D-aspartate (NMDA) receptor antagonist medications to reduce glutamate release due to the proposed role of NMDA receptors in CSD.