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defensive structure consisting of walls or mounds built around a stronghold to strengthen it (同)munition
the addition of an ingredient for the purpose of enrichment (as the addition of alcohol to wine or the addition of vitamins to food)
the art or science of strengthening defenses

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〈U〉(都市などの)武装化,防備を固めること / 〈C〉《通例複数形で》とりで,要塞
spectrumの複数形

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/11/09 19:11:10」(JST)

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Scintillating scotoma, also called visual migraine,^[1] is the most common visual aura preceding migraine and was first described by 19th-century physician Hubert Airy (1838–1903). It may precede a migraine headache, but can also occur acephalgically (without headache). It is often confused with ocular migraine, which originates in the eyeball or socket.

Signs and symptoms

An artist's depiction of a scintillating scotoma with a bilateral arc.

Many variations occur, but scintillating scotoma usually begins as a spot of flickering light near or in the center of the visual field, which prevents vision within the scotoma area. The affected area flickers but is not dark. It then gradually expands outward from the initial spot. Vision remains normal beyond the borders of the expanding scotoma(s), with objects melting into the scotoma area background similarly to the physiological blind spot, which means that objects may be seen better by not looking directly at them in the early stages when the spot is in or near the center. The scotoma area may expand to completely occupy one half of the visual area, or it may also be bilateral. It may occur as an isolated symptom without headache in acephalgic migraine.

As the scotoma area expands, some people perceive only a bright flickering area that obstructs normal vision, while others describe seeing various patterns. Some describe seeing one or more shimmering arcs of white or colored flashing lights. An arc of light may gradually enlarge, become more obvious, and may take the form of a definite zigzag pattern, sometimes called a fortification spectrum (i.e. teichopsia, from Greek τεῖχος, town wall), because of its resemblance to the fortifications of a castle or fort seen from above.^[2] It also can resemble the dazzle camouflage patterns used on ships in World War I. Others describe patterns within the arc as resembling Widmanstätten patterns.

The visual anomaly results from abnormal functioning of portions of the occipital cortex at the back of the brain, not in the eyes nor any component thereof, such as the retinas.^[3] This is a different disease from retinal migraine, which is monocular (only one eye).^[4]

It may be difficult to read and dangerous to drive a vehicle while the scotoma is present. Normal central vision may return several minutes before the scotoma disappears from peripheral vision.

Sufferers can keep a diary of dates on which the episodes occur to show to their physician, plus a small sketch of the anomaly, which may vary between episodes.

Animated depictions

Flickering animation of a scintillating scotoma, where the scintillations were of a zigzag pattern starting in the center of vision, surrounded by a somewhat larger scotoma area with distortion of shapes but otherwise melting into the background similarly to the physiological blind spot.
A depiction of a scintillating scotoma that was almost spiral-shaped, with distortion of shapes but otherwise melting into the background similarly to the physiological blind spot. This depiction shows the type of patterning that some have described as similar to Widmanstätten patterns.
A depiction of a scintillating scotoma that was almost spiral-shaped, with distortion of shapes but otherwise melting into the background similarly to the physiological blind spot.

Causes

Scintillating scotomas are most commonly caused by cortical spreading depression, a pattern of changes in the behavior of nerves in the brain during a migraine. Migraines, in turn, may be caused by genetic influences and hormones. People with migraines often self-report triggers for migraines involving stress and a wide variety of foods.^[5] While monosodium glutamate (MSG) is frequently reported as a dietary trigger,^[6] some scientific studies do not support this claim.^[7]

The Framingham Heart Study, published in 1998, surveyed 5,070 people between ages 30–62 and found that scintillating scotomas without other symptoms occurred in 1.23% of the group. The study did not find a link between late-life onset scintillating scotoma and stroke.^[8]

Prognosis

Symptoms typically appear gradually over 5 to 20 minutes and generally last fewer than 60 minutes, leading to the headache in classic migraine with aura, or resolving without consequence in acephalgic migraine.^[2] Many migraine sufferers change from scintillating scotoma as a prodrome to migraine to scintillating scotoma without migraine. The scotoma typically spontaneously resolves within the stated time frame, leaving few or no subsequent symptoms, though some report fatigue, nausea, and dizziness as sequelae.^[9]

References

^ Prasad, Sashank. "Visual Migraine" (PDF). Brigham and Women's Hospital. Harvard Medical School. Retrieved 4 October 2016.
^ ^a ^b "imigraine.net". imigraine.net. Retrieved 24 June 2015.
^ "imigraine.net". imigraine.net. Retrieved 24 June 2015.
^ "Retinal migraine". Current Pain and Headache Reports. 9: 268–271. doi:10.1007/s11916-005-0035-2. Retrieved 24 June 2015.
^ [1] Archived October 20, 2012, at the Wayback Machine.
^ Sun-Edelstein C, Mauskop A (June 2009). "Foods and supplements in the management of migraine headaches". The Clinical Journal of Pain. 25 (5): 446–52. doi:10.1097/AJP.0b013e31819a6f65. PMID 19454881.
^ Freeman M (October 2006). "Reconsidering the effects of monosodium glutamate: a literature review". J Am Acad Nurse Pract. 18 (10): 482–6. doi:10.1111/j.1745-7599.2006.00160.x. PMID 16999713.
^ Christine A. C. Wijman; Philip A. Wolf; Carlos S. Kase; Margaret Kelly-Hayes; Alexa S. Beiser (August 1998). "Migrainous Visual Accompaniments Are Not Rare in Late Life: the Framingham Study". Stroke.
^ "MIGRAINE IN PATIENTS WITH CLUSTER HEADACHE". Headache: The Journal of Head and Face Pain. 14: 69–72. 2005-06-23. doi:10.1111/j.1526-4610.1974.hed1402069.x. Retrieved 2015-08-19.

Notes

Gardner-Medwin AR (1981). "Possible roles of vertebrate neuroglia in potassium dynamics, spreading depression and migraine". J. Exp. Biol. 95: 111–27. PMID 7334315.
Hadjikhani N, Sanchez Del Rio M, Wu O, et al. (2001). "Mechanisms of migraine aura revealed by functional MRI in human visual cortex". Proc. Natl. Acad. Sci. U.S.A. 98 (8): 4687–4692. doi:10.1073/pnas.071582498. PMC 31895 . PMID 11287655.

External links

AgingEye Times
Youtube Video Depiction of Scintillating Scotoma

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片頭痛患者からみた片頭痛

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Related Pictures

★リンクテーブル★

リンク元	「閃輝暗点」「scintillation scotoma」
関連記事	「fortification」「spectra」

「閃輝暗点」

Scintillating scotoma
	Example of a scintillating scotoma, as may be caused by cortical spreading depression
Classification and external resources
Specialty	ophthalmology
ICD-10	H53.1
ICD-9-CM	368.12
OMIM	613656
eMedicine	neuro/480
MeSH	D012607
	[edit on Wikidata]

　　[★]

英: scintillating scotoma, scintillation scotoma, scintillating blind spot
ラ: scotoma scintillans
同: flittering scotoma、閃光暗点 fortification spectra、星型閃光 teichopsia
関: 暗点、中心暗点、傍中心暗点、盲点中心暗点、輪状暗点

片頭痛の前兆

「scintillation scotoma」

　　[★]

閃輝暗点

関: fortification spectra、scintillating scotoma

「fortification」

　　[★]

n.

強化

関: consolidate、consolidation、enhance、enhancement、fortify、intensification、intensify、reinforce、reinforcement、sharpen、strengthen

「spectra」

　　[★]

np.

スペクトル、範囲、周波数域

関: area、extent、range、reach、realm、scope、spectral、spectrum

[1] Prasad, Sashank. "Visual Migraine" (PDF). Brigham and Women's Hospital. Harvard Medical School. Retrieved 4 October 2016.

[bare_url-2] "imigraine.net". imigraine.net. Retrieved 24 June 2015.

[3] "imigraine.net". imigraine.net. Retrieved 24 June 2015.

[4] "Retinal migraine". Current Pain and Headache Reports. 9: 268–271. doi:10.1007/s11916-005-0035-2. Retrieved 24 June 2015.

[5] [1] Archived October 20, 2012, at the Wayback Machine.

[6] Sun-Edelstein C, Mauskop A (June 2009). "Foods and supplements in the management of migraine headaches". The Clinical Journal of Pain. 25 (5): 446–52. doi:10.1097/AJP.0b013e31819a6f65. PMID 19454881.

[7] Freeman M (October 2006). "Reconsidering the effects of monosodium glutamate: a literature review". J Am Acad Nurse Pract. 18 (10): 482–6. doi:10.1111/j.1745-7599.2006.00160.x. PMID 16999713.

[8] Christine A. C. Wijman; Philip A. Wolf; Carlos S. Kase; Margaret Kelly-Hayes; Alexa S. Beiser (August 1998). "Migrainous Visual Accompaniments Are Not Rare in Late Life: the Framingham Study". Stroke.

[9] "MIGRAINE IN PATIENTS WITH CLUSTER HEADACHE". Headache: The Journal of Head and Face Pain. 14: 69–72. 2005-06-23. doi:10.1111/j.1526-4610.1974.hed1402069.x. Retrieved 2015-08-19.

v t e Phenomena of the visual system
Entoptic phenomena	Blind spot Phosphene Floater Afterimage Haidinger's brush Prisoner's cinema Blue field entoptic phenomenon Purkinje images
Other phenomena	Aura Form constant Scintillating scotoma Palinopsia Visual snow Afterimage on empty shape Cosmic ray visual phenomena Scotopic sensitivity syndrome

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fortification spectra