Another Reminder: Retinal Migraine may not be what it seems…

There has been a lot of confusion about retinal migraine over the years. We’ve all heard of migraine with aura – an attack which includes “aura” symptoms, usually visual.

Retinal migraine is a specific type of migraine with aura. It involves symptoms such as blindness, a blind spot, or patterns/flashes of light, but only in one eye. And always temporary.

Recently a report was published about a 47 year old woman who was diagnosed with retinal migraine. She had temporary blindness in one eye, and headache on the same side. This went on for a year, then 15 months.

Medication was a help – in this case, topiramate and propranolol.

But when these were discontinued, the symptoms eventually returned.

Now as we’ve talked about before (see “What is Retinal Migraine?”), it’s very important to see a doctor and rule out other possible diagnoses. In this case, it wasn’t migraine at all, but something else that looked a lot like it.

This woman actually had isolated orbital vasculitis, which involves an inflammation of the walls of certain blood vessels. When treatment for this condition was give (steroid pulse therapy), the symptoms cleared up completely.

The correct diagnosis was finally made using high-resolution vessel wall magnetic resonance imaging.

There are many conditions that “look like” various types of headache conditions, and may be resolve or temporarily resolve or appear to resolve using standard medication. But it’s still important to investigate other possibilities. In this case, it would have saved one woman months of disabling symptoms.