A diagnostic sign in migraine?
At the bedside it was noted that, after ocular fundoscopy, patients with migraine complained more often of an after-image than did non-migraineurs. This phenomenon was then investigated in consecutive patients attending a general neurology outpatient clinic. The relative risk for the diagnosis of migraine in patients reporting an after-image was 2.91 (95% confidence interval 1.96 to 4.34), and the sensitivity, specificity and positive predictive value of this observation for the diagnosis of migraine were 0.63, 0.75 and 0.55 respectively. After-images were equally likely to be reported by migraineurs with and without aura, and by patients with migraine equivalents. The after-image phenomenon probably reflects the heightened sensitivity to visual stimuli of patients with migraine. Although a diagnosis of migraine is primarily established by the patient's history, the presence of an after-image following ocular fundoscopy may support this diagnosis.
de Silva
R N
RN
Department of Neurology, Essex Centre for Neurology & Neurosurgery, Oldchurch Hospital, Romford RM7 0BE, UK.
D000293:Adolescent; D000328:Adult; D000360:Afterimage; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000523:psychology; D009887:Ophthalmoscopy; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity