1.2.1.2 Typical aura without headache

Identification: Female patient, 32 years old, university professor.

Clinical History: The patient reports recurrent episodes of visual symptoms for approximately 6 months. She describes the sudden appearance of a bright "zig-zag" shaped spot in the left visual field, which progressively expands over about 20 minutes, followed by a scotoma (area of visual loss) in the same location. The episodes occur 1 to 2 times per month, without association with headache or other symptoms. The patient denies photophobia, phonophobia, nausea, or vomiting during the episodes. She reports that the visual symptoms temporarily interfere with her ability to read and work, but completely disappear after 30 to 40 minutes.

Personal History: History of migraine with aura during adolescence, which spontaneously resolved at age 20. Denies other neurological or systemic diseases.

Physical and Neurological Examination: Unremarkable. Normal fundoscopy. Visual fields by confrontation normal outside of episodes.

Complementary Investigation: Cranial MRI and brain MR angiography normal. Interictal electroencephalogram (EEG) without abnormalities.