A 16-year-old male was brought with removal of clothes while watching movies complaints of seeing wave like forms and sudden monocular blindness. The diagnosis is
High-Yield Explanation
(A) Migraine # BASILAR MIGRAINE: Symptoms referable to a disturbance in brainstem function, such as vertigo, dysarthria, or diplopia, occur as the only neurologic symptoms of the attack in about 25% of patients. Adramatic form of basilar migraine (Bicker-staffs migraine) occurs primarily in adolescent females.> Episodes begin with total blindness accompanied or followed by admixtures of vertigo, ataxia, dysarthria, tinnitus, and distal and perioral paresthesias. In about one-quarter of patients, a confusional state supervenes. The neurologic symptoms usually persist for 20 to 30 min and are generally followed by a throbbing occipital headache. This basilar migraine syndrome is now known also to occur in children and in adults over age 50. An altered sensorium may persist for as long as 5 days and may take the form of confusional states superficially resembling psychotic reactions. Full recovery after the episode is the rule.