Acephalic (Ocular or Eye) Migraine

Acephalgic migraine (also called optical migraine) is a neurological syndrome. It is a relatively uncommon variant of migraine in which the patient may experience aura (light disturbances), nausea/vomiting, photophobia (light sensitivity), hemiparesis (distortion of side/peripheral vision often as a zig zag curve) and other migraine symptoms but does not experience headache.

 

Acephalgic migraines can occur in individuals of any age. Though there are some individuals—more commonly male—who only experience acephalgic migraine. Frequently patients also experience migraine with headache. Generally, classical migraines with headaches are more than twice as likely to occur in females than males.  Individuals who experience acephalgic migraines only in childhood are highly likely to develop typical migraines as they grow older.  Among women, incidents of acephalgic migraine may increase during perimenopause.

 

Scintillating scotoma is the most common symptom. Also frequently reported is monocular central blindness. Acephalgic migraines typically do not persist more than an hour and may last for as little as 60 seconds. On rare occasions, they may continue for up to two days.

 

The prevention and treatment of acephalgic migraine is broadly the same as for classical migraine but, as the symptoms are usually less severe, treatment is less likely to be required.