Bitemporal hemianopsia as a prodromal symptom of ophthalmic migraine: A report of three cases

Abstract

Visual disturbances in migraine usually are congruent in the homonymous fields, while bitemporal field defects are very rare in migrainous prodromes. Three cases of ophthalmic migraine with bitemporal hemianopsia during the prodromal stage are presented, and the pathogenesis of visual disturbances in migraine, especially with regard to bitemporal hemianopsia, is discussed.

The pathogenesis of migraine with bitemporal hemianopsia is unknown, but the authors consider that the transiently microcirculatory disturbances of the chiasma may be caused by vascular spasms or precapillary shunting associated with an altered sympathetic response because of instability of the autonomic nervous system.

Key Words:

• bitemporal hemianopsia
• ophthalmic migraine
• vasospasm
• chiasma
• autonomic nervous system