title: Transient visual disturbances in adolescents: migrainous feature or headache-accompanied phenomenon?
abstract: OBJECTIVE
  To investigate the prevalence, characteristics and clinical correlates of transient visual disturbances (TVDs) in adolescents with headaches.
  
  
  METHODS
  We surveyed headache-related TVDs in the past three months in two middle schools. All the ninth-grade students filled-in the questionnaires including demographics, a validated headache questionnaire, and visual phenomenon questions embedding the Visual Aura Rating Scale (VARS). TVDs were defined as transient visual phenomena corresponding to a headache attack, but not visual aura, i.e. VARS <four.
  
  
  RESULTS
  Six hundred and sixty-three adolescents (341 boys and 322 girls; mean age 15.1 ± 0.3 years old) participated in this study. In subjects reporting at least one headache during the past three months (N = 371), 33.4% reported TVDs, which accounted for 18.7% in total participants. TVDs were described mainly as flickering lights or scotoma, movable, monochromatic, occurring over bilateral visual fields, developing and lasting <30 seconds, and experienced during the headache phase. Subjects with migraines reported a higher frequency of TVDs than those with non-migraine headaches (67.1% vs. 31.2%, p < 0.001). TVDs were independently associated with photophobia (OR = 12.6, p < 0.001) and pulsatile headache (OR = 2.1, p = 0.012).
  
  
  CONCLUSIONS
  The major features of TVDs were distinguishable from visual aura. TVDs were common in adolescents with headaches, especially in migraineurs.
authors.affiliation: Department of Neurology, Taipei Veterans General Hospital, Taoyuan Branch, #201 Shi-Pai Road Section 2, Taipei, Taiwan.
authors.forename: Hung-Yu
authors.initials: HY
authors.lastname: Liu
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Shiang-Ru
authors.initials: SR
authors.lastname: Lu
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Chen
authors.forename: Chi-Hsiang
authors.initials: CH
authors.lastname: Chou
authors.forename: Yen-Feng
authors.initials: YF
authors.lastname: Wang
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology*