My wife is 33 and has had migraine without pain since her teens.
They've always followed a similar pattern, a short period (2 mins) of
visual distortion/voids/grey-outs followed by zig-zag lines.  They've
always gone within 30 mins.  She would get them say twice/three times
a month.

Last Sunday the usual 2 min experience begain and she assumed a
migraine was coming.  This time however, it did not progress to the
zig-zag lines stage and has stayed with her for the past 8 days.  Both
eyes are affected, but she has a very hard time describing to me
exactly what she's seeing.

She is very worried that it has become permanent, as it's never even
lasted an hour previously.  We went to see a Neurologist on Friday (6
days in) who was very matter of fact and prescribed Topamax, 25mg per
day rising to 75mg per day in increases of 25mg every third day.

She took one on Friday night and didn't like the effects, slurred
speech, memory loss, smelling strong perfume and the need to sketch
pictures of perfume bottles at 4am.  Saturday night she didn't take
one, but having had no improvement in the visual disturbance she has
taken one tonight.

I can't help but feel that this is not a migraine.  There are a few
other interesting factors:

1. If she covers one eye and focuses on something, after a few seconds
she reports that "everything is going dark".
2. She had a series of heart attacks at age 13 followed by complex
surgery.  Since the age of 25 she has been taking Bisoprolol beta
blockers to maintain a good heart rhythm (she developed an irregular
heart beat at 25 which she still has now).
3. She had a funny episode 3 years ago, was sitting on the sofa and
suddenly didn't know where she was, she said everything went dark.
Lasted about 2 mins.  She has reported having "black-outs" when she
stands from a sitting position, on and off since then.
4. When she was 18, she had a similar visual disturbance to the one
she's having now, but only for a few hours.  When it finished, she
permanently lost a "slice" from her field of vision in one eye - if
she reads text now the text just prior to it on the line "vanishes".

Any ideas?  Neuro didn't offer any scans of any kind, I have a nagging
feeling he was too quick to judge.  Would be helpful if somebody else
has had a history of "normal" painless migraine followed by a very
long episode like this and come through it.

Not sure what my next move in, we saw the Neurologist privately, we
also have a backup NHS referral but they haven't even got in touch yet
despite me calling with some urgency last Thursday.

BP is normal apparently.  Her field of vision is extremely impaired at
present.

Simon