Amaurosis fugax, a sudden, transient monocular loss of vision resolving in 5 to 10 minutes, is reported in five teenagers from the British Columbia’s Children’s Hospital, Vancouver, BC, and The Hospital for Sick Children, Toronto, Canada. Four patients had a history of common migraine at other times or a family history of migraine. Unlike adults in whom amaurosis fugax is associated frequently with atherosclerosis of the internal carotid artery and a herald of stroke, these symptoms in children may represent a migraine variant, and cerebral angiography is usually unwarranted. [1]
COMMENT: The causes of amaurosis fugax are diverse and include carotid atheromatous disease, Raynaud’s disease, temporal arteritis, sickle cell anemia, optic nerve tumor, hysteria, as well as migraine. Patients who describe a characteristic mosaic or jigsaw pattern of transient monocular blindness are more likely to be suffering from migraine than carotid atheromatosis, especially in children and adolescents.
On the subject of migraine, Peroutka SJ of Stanford University Medical Center has demonstrated that a large number of migraine prophylactic agents, including propranolol, methysergide, cyproheptadine, and pizotifen, share an ability to interact with 5-hydroxytryptamine (serotonin) receptor subtypes in human brain. This property is offered as a method of selection of drugs for clinical trial in migraine. [2]