Recurrent Stereotyped Episodes in Cerebral Amyloid Angiopathy: Response to Migraine Prophylaxis in Two Patients
A 72-year-old woman had an 8-week history of colorful flashes of different jagged shapes including pinwheels throughout both visual fields lasting up to 30 min between 5 and 10 times per day. Exam was normal. The episodes completely resolved on verapamil 240 mg a day. Four months later, she blacked out while driving and 3 days later ‘lost her color vision’. CT showed an acute right occipital hemorrhage. Color vision returned 4 days later. The visual phenomena recurred but were reduced in frequency on verapamil 120 mg. MRI GRE showed multiple focal areas of subcortical hemosiderin typical for CAA.