Abstract
We appreciate Dr Panayiotopoulos’s comments about our study ‘Characteristics of migraine visual aura in Southern Brazil and Northern USA’ (1).
We agree that neither the color nor the round shape of the aura, as isolated features, is enough to distinguish between occipital seizures and migraine visual auras. However, we have frequently seen, in our own experience, as well as in presentations by neurologists and/or headache specialists, that these aspects of the aura are overemphasized as the main characteristics distinguishing the two conditions. In our paper, we have clearly shown that many patients with migraine with aura, diagnosed by headache specialists, reported having colored visual auras and/or visual phenomena with a rounded shape. Therefore, other features, like duration, location, type of onset, movement across visual fields, and repetition of the pattern of the visual aura, are also as important in making the diagnosis of these migraine auras, in our opinion.
The aim of our study was not to describe difficult cases in which some unique or special characteristics of the visual phenomena distinguished between occipital epileptic seizures and migraine visual auras; but what we wanted to show, and did show, was the heterogeneity of these features in a group of ‘real world’ patients with migraine with aura. A prospective study may clarify these areas in the future.