Eren Ozan E, Straube Andreas
Neurologie, München Klinik Bogenhausen, München, Deutschland.
Neurologie, Klinikum der Universität München, Marchioninistraße 15, 81377, München, Deutschland.
Nervenarzt. 2023 Apr;94(4):344-352. doi: 10.1007/s00115-023-01466-8. Epub 2023 Apr 11.
Temporary and persistent visual phenomena are a frequent reason for a neurological presentation. The diagnosis can usually be made with the help of a structured anamnesis with determination of the time of onset, the course and symptoms as well as the monocular vs. binocular manifestation. The visual aura in migraine is certainly the most frequent entity to be differentiated. In particular, persistent visual phenomena such as visual snow syndrome, hallucinogen persisting perception disorder and the Charles Bonnet syndrome (CBS) seem to be underdiagnosed in clinical practice for various reasons and are probably not that rare. Instrumental diagnostics are mostly used for exclusion diagnostics and are a component of a complete patient education, but can be indicative for certain questions (CBS, epilepsy). This article presents the most frequent visual phenomena from the neurological practice and their differential diagnoses, guided by a case history.
暂时性和持续性视觉现象是神经科就诊的常见原因。通常借助结构化问诊来进行诊断,包括确定发病时间、病程、症状以及单眼与双眼表现。偏头痛的视觉先兆无疑是最常需鉴别的情况。特别是,诸如视觉雪综合征、致幻剂持续性感知障碍和查尔斯·邦尼特综合征(CBS)等持续性视觉现象,由于各种原因在临床实践中似乎诊断不足,可能并非那么罕见。器械诊断大多用于排除诊断,是患者全面教育的一部分,但对某些问题(如CBS、癫痫)可能具有指示作用。本文结合病例史介绍神经科实践中最常见的视觉现象及其鉴别诊断。