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Images in Neurology
September 2018

Visual Phenomena in Occipital Lobe Epilepsy: “It’s Beautiful!”

Author Affiliations
  • 1Department of Neurology, University of Washington, Seattle
  • 2Neurological Associates, HCA Virginia, Richmond
  • 3Epilepsy Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington
  • 4Department of Physiology and Biophysics, University of Washington, Seattle
JAMA Neurol. 2018;75(9):1146-1147. doi:10.1001/jamaneurol.2018.2144

A 71-year-old man presented with new-onset headache and transient visual phenomena. He characterized the headache as moderate in severity, with pressurelike, holocephalic pain. He described his visual symptoms as episodes of bright colors and flashing lights in his right visual field; describing such an episode, the patient said, “It’s beautiful!” Visual symptoms lasted from 30 to 90 seconds per episode and were occurring several times an hour over 5 days, prompting an emergency department visit in which he was treated with intravenous saline and ketorolac for a presumed migraine with visual aura. However, the patient did not improve and continued to experience a headache and frequent episodes of transient visual symptoms.

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