1.4.4 Migraine aura-triggered seizure

A 45-year-old warehouse supervisor reports the third such lifetime episode of a witnessed convulsion, this time prompting his wife to call an ambulance. He describes a preceding visual disturbance of bright, sparkling lights, a positive symptom, restricted to his right visual field. This attack of visual aura and pounding headache had been building for a few minutes when, while the visual disturbance and headache were still ongoing, he suddenly became unresponsive. His wife described generalised limb stiffening and rhythmic jerking lasting about ninety seconds, followed by postictal drowsiness. He confirms that the pounding headache had come on within the hour of the visual symptoms starting, matching its side to the visual disturbance exactly, and his wife gave a consistent account of the sequence on direct questioning.