An 18-year-old woman has periodic episodes that begin with severely decreased vision, followed by ataxia, dysarthria, and tinnitus. The symptoms last for 30 minutes and are then followed by a throbbing occipital headache.Which of the following is the most likely diagnosis?
(A) vertebral-basilar insufficiency
(B) chronic basilar artery dissection
© classic migraine
(D) ophthalmoplegic migraine
(E) basilar migraine
solution:
(E) Basilar migraine can be very dramatic, and can resemble ischemia in the territory of the basilar posterior cerebral arteries. The visual symptoms of basilar migraine typically affect the whole of both visual fields, and can even cause temporary cortical blindness. There can also be an alarming period of coma or quadriplegia