This is one of the toughest questions in migraine pathophysiology.
I have described my own scintillating scotoma in the attached file.
I am currently in the process of submitting an exhaustive review on CSD following the commissioning of the article by Editor-in-Chief of Journal of Neuroscience, having performed an exhaustive search of the scientific literature.
To be homonymous, the SS must be binocular and distributed in both right or both left halves of the visual fields of both eyes. I have not found any such case of SS distributed in a binocular fashion.
I have also described the basis for retinal origin of SS in the attached article. No in vivo proof can ever be obtained of mechanically-triggered SS at the level of the retina.
Thank you for your interest, Raed.
The SS is reported by the majority of publications available as being mononocular, as starting specifically in the paramacular region of the temporal side of the visual field eye. The SS of migraine NEVER covers the whole half of any visual field -- this is an absolute statement that I am making for your sake.
I suggest you study the issue a bit more in depth. If you cannot conclude on the same lines, I suggest you wait for the publication of my invitational major review in Journal of Neuroscience. Patients worry about the whole visual field -- it is their doctors who make presumptions and suggest answers to them on the basis of their "scientific knowledge".
There is nothing like default in Medicine. Medical science is not computer science -- by any yardstick or default.
Raed Behbehani added an answer to your question:
Has a homonymously-distributed positive scintillating scotoma ever been described in / by a migraine patient?
ALL ANSWERS DELETED BY NEURO-OPHTHALMOLOGIST Raes Behbehani himself.
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Thank you for your interest, Raed.
As an Ophthalmologist, you might not be able to appreciate the complexities of cerebral cortical function. There is, again, I say with the greatest emphasis possible, no evidence that the occipital cortex is involved in migraine.
There is indeed a method (actually 3 methods) for differentiating what the patient says and what really happens to her/him at the level of the eye. You should try to find that out, rather than replying so quickly to me. When I give you a constructive suggestion, you do not seem to read it. I will not repeat the same again.
Please do not write back to me without any reference to support to your point of view.
@ Raed Behbehani
Thank you for telling me that I am not modest, just because I asked you to provide references to support you review.
In addition, you removed your horrible comment and all your previous comments also. That is in itself a crime as far as science is concerned AND clearly shows that you think you are above science simply because you have qualified as a Neuro-Ophthalmologist. It is scientists like you that give a bad name to Science itself. In my evaluation, you are not fit to work as a doctor, far less than a researcher.
Well done, Raed (Baha-Ophthalmology Centre).
Mabrook, habibi.
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