Bidot S, Biotti D
Fondation ophtalmologique Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France; Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
Service de neurologie B4, bâtiment Pierre-Paul-Riquet, place du Dr-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
J Fr Ophtalmol. 2016 Jun;39(6):554-9. doi: 10.1016/j.jfo.2016.05.002. Epub 2016 Jun 17.
Migraine with visual aura is marked by recurrent episodes of transient visual disturbance, often followed by headaches. Its pathophysiology has not been fully understood, but visual auras might be related to a self-propagating wave of cortical depolarization called "cortical spreading depression", triggering a trigemino-vascular "storm" ultimately leading to headaches. The most specific visual symptom is the "fortification spectrum" consisting of glimmering jagged lines spreading from the center to the periphery, and leaving a transient scotoma in its wake. Other visual symptoms are numerous, ranging from elementary positive or negative visual phenomena to complex and elaborate hallucinations. The diagnosis can be made according to the International Classification of Headache Disorders revised in 2013. The main goal of the treatment is to relieve the patient's pain quickly and to decrease the frequency of the episodes.
伴有视觉先兆的偏头痛以反复发作的短暂视觉障碍为特征，通常随后会出现头痛。其病理生理学尚未完全明确，但视觉先兆可能与一种称为“皮质扩散性抑制”的皮质去极化自传播波有关，这种波会引发三叉神经血管“风暴”，最终导致头痛。最具特异性的视觉症状是“堡垒光谱”，由从中心向周边扩散的闪烁锯齿状线条组成，并在其后留下短暂的暗点。其他视觉症状多种多样，从基本的阳性或阴性视觉现象到复杂精细的幻觉。诊断可依据2013年修订的《国际头痛疾病分类》进行。治疗的主要目标是迅速缓解患者的疼痛并减少发作频率。
