Which visual phenomenon is characterized by fortification spectra or crescent-shaped scotomata and often precedes a headache?

• A. Migraine aura visual hallucinations
• B. Seizure-induced visual hallucinations
• C. Narcolepsy visual hallucinations
• D. Neurodegenerative visual hallucinations

Answer: (A)

Classic migraine aura visual phenomena are being tested here. Fortification spectra appear as zigzag, shimmering lines that seem to rise and shift across the visual field, while crescent-shaped scotomata look like partial, crescent-like losses in vision. These patterns typically begin gradually, unfold over several minutes, and are often followed by a migraine headache. They reflect transient cortical spreading depression and are the hallmark of migraine with aura. This distinguishes them from seizure-related visual hallucinations, which are usually brief, variable in form, and not reliably preceded by headache, as well as from narcolepsy hallucinations (sleep-wake transition phenomena) and neurodegenerative visual hallucinations (more complex, often tied to dementia or parkinsonian conditions).