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Reviews
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What are the main claims of the paper and how important are they?
The author claims in a case vreport that it is possibly1 of 41st case of migraine with persistent aura without infarction and compares it with the recently describes neuro myelitis optica in cases of multiple sclerosis aqnd gives reason for persistent bilateral oscillopsia to sustained cortical occipital; hyperexcitiability and from reverbrating spreading cortical depression-although it may be so the author has not got any confirmatory tests like magnetoencepalography(MEEG) as in studies by Chen et al(who had reported 40 cases till date) or apparent water diffusion coefficient(ADC) magnetic rfesonance image during a prolonged aura as by belvis r et al or MR perfusion imaging studies as by florey et al and although chen et al used magnetoencephalography they still gave limitations of studying only 6 patients with persistent aura saying it is impractical to obtain a complete magnetoencehalography recording in presence of typical aura and to verify pathophysiologicak link of persistent visual aura to cortical spreading depression reverbrations by elucidating effects of single cortical spreading depression propagation and they planned rpt MEEG after resolution of persistent visual aura to disentangle the puzzle.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
it would be novel say a 41st case had the corrrobotating investigations like MEEGbeen doneas by Chen WT et al -Sustained visual cortex hyperexcitability in migraine with persistent visual aura-BRAIN-2011;134:2387-2395.
2. Evans RW,Aurora SK,-Migraine with persistent visual aura-HEADACHE 2012;52:494-501.
3. Belvis R et al -Brain apparent water diffusion coefficient magnetic resonance image during a visual ayra-HEADACHE-2010;50:1045-9.
4. fLOERY D et al-Acute onset migrainous aura mimicking acute stroke-MR perfusion imaging feautures
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Are the claims properly placed in the context of the previous literature?
Yes
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Do the results support the claims? If not, what other evidence is required?
It would be novel say a 41st case had the corrrobotating investigations like MEEGbeen doneas by Chen et al or ADC as by Belvis R or MR perfusion studies as by Floery et al although clinically it does appear with the kind of progression and resolution of oscillopsia following topiramate that it may be a case of persistent visual aura in a migrainous patient presenting as bilateral peripheral oscillopsia.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
Its a case report
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Its a case report
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
It woul;d have had the author had the tertiary tests available like MEEG,ADC,,FUNCTIONAL MRI,TMS available during and in interictal period when the oscillopsia was present-at present i dont thing now even with availability it will add much information since it subdided longtime back with topiramate.The author also needs to correcvt the syntax on pafe 4 where twi sentences would make sense if in line 5 of 2nd column patient's inability is used instead of patient impossibility and in line 46 column2-In this patient instead of if this patient migrainousetc.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
No
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Other Comments:
Although authors interpretation is alright it is understandable that in the absence of access to sophisticated testing -it not being a terttiary institution there are limitations to extensive investigations and normally that shouldnr be a deterrant factor if an accurate outcome is achieved and even till date exact pathophysiology of migraine with persistent aura is not well understood and even with MEEG you can not say that final assumptions can be made as concluded by chen et al and patient ay nit cooperate for further investigations once problem is overcome.
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Competing interests:
None
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
Have treated women with migraine with or without aura who present with infertility and migraine being more prevalent in women one tends to see a lot with problems of using oestrogen in such cases for fear of precipitating migrainous attacks during an ivf protocol.
- How to cite: Kaur K K.Migrainous Binocular Peripheral Oscillopsia- A Typical Persistent Visual Aura Without Infarction[Review of the article 'Migrainous Binocular Peripheral Oscillopsia: A typical Persistent Visual Aura Without Infarction ' by Jacome D].WebmedCentral 2013;4(2):WMCRW002480
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A young female consulted with the doctor about the rapid development of “shaky vision”(binocular visual oscillopsia) with irregular trembling of objects or any background on the periphery of the visual fields without specific direction. Her symptomsappeared when attempting central fixation on any given target, associating with initially with lightheadedness, photophobia, mild postural imbalance and a moderately intense mid-facial pain. Her cranial neurological and EEG, brain MRI and MRI of the intra and extra-cranial circulation were normal. The author argued that this patient had cortical oscillopsia without nystagmusprobably with occipital cortical dysfunction including demyelinating lesions over the occipital lobes, corpus callosum and occipital lesions involving parietal area V5 from the previous reports.
Yes
Yes
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NA(because of a case report)
NA(because of a case report)
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No
If more examination (for example, histological study on the occipital lobe) on this patient will be possible, more clear the cause of this symptom. The names of authors are missing in the reference 5.
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No
No
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No