Visual Aura in Migraine: An Analysis of 165 Patients in a Tertiary Care Hospital in North India

Background Migraine auras are transient neurological symptoms, usually lasting for approximately 5 to 30 minutes before the onset of migraine pain. Out of various types of auras, visual aura is the commonest and has variable manifestations, forming approximately 90% of auras. These visual auras may be of particular interest to the ophthalmologist as well as to the neurologist. We planned to conduct this study to look for the prevalence of visual aura in our population and make a descriptive analysis of the same. Materials and Methods It was an observational, questionnaire-based cross-sectional study, enrolling all the consenting patients of migraine. Migraine was classified by International Classification of Headache Disorders (ICHD)-III β version, Third edition of International Classification of Headache Disorders. Patients in whom aura was present, detailed profile of visual aura was made regarding its type, duration, relation with migraine as per its laterality, etc. Observations and Results Out of 1,245 migraine patients, 165 (13.25%) patients reported to have visual aura, 127 females and 38 males. Scintillating scotoma was the commonest type of visual aura, then zigzag lines, blurred vision, and tunnel vision. Majority of patients had aura between 5 and 35 minutes, none had more than 60 minutes. A total of 142 patients out of 165 had unilateral aura, out of which 64 (38.78%) patients had aura ipsilateral to the side of headache, and 78 (47.27%) patients had aura contralateral to the side of headache. Twenty-three (13.93%) patients had bilateral aura. Discussion The frequency of visual aura was found to be 13.25% in our study, which is high compared with previously published Indian data. We did a descriptive analysis of visual aura symptoms. Conclusion Visual aura is the commonest type of aura, more frequent in females. Scintillating scotoma was found to be the commonest type of visual aura, followed by zigzag lines in study. Our study is unique of its type as its shows a descriptive visual analysis in a larger number of patients.