Abstract
Migraine aura manifests as various neurological symptoms, which may occur before, during, or persist throughout the headache phase. We report a case of a 30-year-old female patient whose initial symptoms included persistent bilateral photopsia and ophthalmoplegia, accompanied by headache, with a medical history spanning over four years. The duration of her auras was up to one month. After admission, through detailed inquiry into her medical history and extensive etiological screening, the patient was diagnosed with chronic migraine (CM). Following preventive treatment for CM, her symptoms significantly improved. This case serves to encourage neurologists to expand their diagnostic thinking in clinical practice. When encountering sudden and unexplained persistent neurological symptoms, the possibility of migraine with persistent aura should be considered. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-026-04732-9.