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A 53-year-old male was admitted to our headache outpatient center with a 3-month history of repeated visual disturbances, in which a central scotoma was bordered by a crescent of scintillating zigzag patterns, which slowly advances to the edge of the visual field. Usually this visual phenomena march slowly across the visual field over a period of 20–30 min, with a frequency of one to two attacks a week. Initially, no headache followed this visual sensation. In the last 2 weeks prior to admission, similar attacks occurred more frequently, up to 5–7 times a day, with accompanying unilateral sensory disturbances, described as pins-and-needles sensations, traveling from the left face to the left hand. Similar to the visual symptoms, paresthesias spread from one side of the left face to the left hand and march slowly down the left arm and limb. Numbness occurs following the paresthesia as well as moderate, throbbing headache with nausea. The duration of these attacks including visual and sensory disturbances and headache lasts approximately 3 h, so nearly the whole day was filled out with these phenomena. Headache symptoms were sufficiently treated with acetylsalicylic acid, however, with no influence on the visual and sensory disturbances.
KeywordsMigraine With Aura International Headache Society Sensory Disturbance Central Scotoma Headache Symptom
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