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It may occur as an isolated symptom without headache in acephalgic migraine. While many variations occur, the scintillating scotoma usually begins as a spot of flickering light in the center of the visual fields, which obscures vision to some degree. It then expands into shimmering arc(s) of white or colored lights. The arc of light gradually enlarges, becomes more obvious, and may take the form of a definite zig-zag pattern, sometimes called a fortification spectrum, because of its resemblance to the battlements of a castle or fort seen from above. It may be bilateral or unilateral. It may be difficult to read or drive while the scotoma is present, although normal central vision may return several minutes before the scotoma disappears at the periphery.
Symptoms typically resolve within 15-30 minutes, leading to the headache in classic migraine, or resolving without consequence in acephalgic migraine.
- AgingEye Times
- Imigraine.Net - includes images of scintillating scotomata
-  - moving image of migraine aura
- Gardner-Medwin AR (1981). Possible roles of vertebrate neuroglia in potassium dynamics, spreading depression and migraine. J. Exp. Biol. 95: 111–27.
- Hadjikhani N, Sanchez Del Rio M, Wu O, et al (2001). Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc. Natl. Acad. Sci. U.S.A. 98 (8): 4687–92.
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