Cos I know I have some knowledgeable readers.
So right now I am sitting in a darkened office, with brilliant jagged geometric shapes floating in my right visual hemisphere. Having just taken my Maxalt, I am hopeful that they will disappear soon, and that they will not be replaced by an exploding horrific headache.
But the questions…
This time, the colors are different from earlier visual migraines. Less bright colors, sometimes appearing to be a palate of grays. It also appears more melty than usual. Oh, and this one is confined to my right visual hemisphere.
So, does that mean vascular activity in left occipital lobe? Or could it be elsewhere in the various visual pathways? More generally, could one conceivably map the location in the brain where the migraine activity is happening by attending to the visual phenomena? (Has this been done?)
The NYTimes had (has?) a blog on migraine art; there is quite a lot of variation. I tend to get the current effect (location varies, as does color scheme now), and occasionally a different sort where it looks like I am viewing the world through a cracked stained-glass window. Would different sorts of visual experiences imply different, and specifiable, brain areas of vascular weirdness.
Signing off now–my right eye is beginning to throb, which is not a good sign.
I am not a neuroophthalmologist, but IIRC the phenomenon of unilateral hemianopsia is caused by a lesion at the optic chiasm right above the pituitary. So that’s where I’d put my money on the vascular changes for this migraine.
All medical curiosity aside, I hope you feel better soon. Migraines are assholes.
You may actually be experiencing a retinal migraine, where the activity is in the eye itself. Those…tend to suck. Sorry.
All those pretty colors and interesting geometric shapes… sound absolutely awful. May this be the last one you ever get!
*virtual hug*
I recall reading about some guy who experienced an aura like that and happened to be in front of an ophthalmologist’s office. The doctor examined his eyes and saw vascular disturbances in his retina that matched the location of the symptoms, leading to a lot of new research into the subject.
I occasionally get such migraines, brought on by stress and certain preserved foods. (Damn. I like pickled herring!) If I take Exedrin (Extra Strength or Migraine (the difference is a few dollars per bottle)) at first symptoms, then I just get a headache.
In any case, I ride them out: I hide in a dark and quiet room for the rest of the day. Keep well hydrated.
Health and good luck to you…
Thanks, all! An hour in a dark room, some food and water, and a miracle of modern medicine later, I appear to have dodged the pain.
Re: retinal migraine–I was told by a vision researcher that the way to eliminate that possibility is to check whether the image goes away (or changes) when you shut one eye or the other. Mine does not, so I’m assuming (and could be wrong, of course) that it’s further back in the system. But I don’t know, and wouldn’t have even thought to examine the possibility without my brilliant readers!
Variations in migraine weirdness (including some far weirder than yours) still seem to generally fall into the unfortunately-populous category of medical phenomena that aren’t well-understood.
In brief:
http://www.allaboutvision.com/conditions/ocular-migraine.htm
In depth:
http://www.sibelium.com.cn/sibelium/WX/fulltext_WX_2/038.pdf (2007)
(Noteworthy quote for your situation: “There are patients who recurrently present one type of aura for many years, and change to a new pattern without obvious reasons.”)
Sweet!
(And I must say, it is nice that I have my vision back to read it! A few years ago I had a real scare, when following one of my visual migraines, I couldn’t read–I knew there were letters there, but there were no functional words.)
I’m a headache neurologist (university based) and your idea that the visual aura is in your cortex is correct. Right visual field (both eyes) is represented by the left occipital cortex.
The activity in the brain from migraine visual aura has been imaged in PET and functional MRI scan. Research suggests it is due to a metabolic or functional change, not actually due to ischemic or vasoconstriction. Couple of references if you are interested:
Unrelated question, tac–I have made plans to donate my brain to Cuttlefish U. (well, after I’m done with it); I plan to do some videos about my brain to show along with it to bio, psych, or whatever classes…because students all ask questions about “whose brain is it?”. Anyway, I would love to do a series of videos with various researchers, using whatever methods they use (PET, FMRI, etc.) to include with this. Hell, I’d love to do it as a series for PBS. Anyway, any advice? What sorts of methods should I be looking to include? Got any connections? Wanna look at my brain?
eta–oh, and thanks for the references!
I used to have ocular migraines. They were caused by my eyes not properly focusing. After 30 minutes of reading the print would go out of focus and I would often get the ocular migraines. I told two different optomologists about the problem and they just brushed me off, saying I was getting old.
The third one I talked to checked my eyes and found that one eye was focusing higher than the other. She prescribed prisms in my reading glasses to level the view from both eyes. It solved the problem completely; no more migraines and no more reading focus problems. Hope that helps.
I’ve had visual migraines occasionally for many years. I’m one of the lucky ones and I seldom get the headache or nausea (though about once in ten years I do).
But last year I woke up one morning and was seeing double. Completely split vision, two of everything. It did not go away after a couple of minutes. Since I was 60 years old and so forth, I thought it might be a stroke (double vision is a possible symptom).
By the time I got to the ER I just had very blurred vision. About an hour later, I realized that the “thick” feeling in my head (not quite a headache, but definitely something) was familiar. Then I realized that what I had experienced was a migraine of a type I had never even heard of before. They CAT scanned me, of course, just to be sure, but by the time I left the hospital, it was all over.
Cuttlefish, migraines do change sometimes and that is not necessarily a sign of something worse, but if you are at all concerned, I would go to the doc.
Cuttlefish—I don’t know if I can help with the video+brain imaging questions—I’m mainly clinical, and don’t interact with the imaging research people at my institution. Depending on where you live, you could contact the PET scan department and ask for a research “Fellow” and see if they are looking for volunteers.
One of the leading migraine imaging people recently joined UCSF Neurology (where I trained, maybe before dinosaurs became oil): Peter Goadsby, M.D., Ph.D.
If you want to discuss this further you could email me at colli037 at yahoo dot com
Glad you’re feeling better, Cuttlefish! Even gladder that I don’t experience migraines.
Completely off topic: May I assume you’re still following Sailor Twain? I followed your link to it a long time ago and was instantly hooked. Things are getting intense. I can’t stand the wait for Mondays, Wednesdays, and Fridays.
Oh, absolutely, Treb! Makes me wish I could draw… or manipulate time, so that I can read the rest of it NOW! What gets me is, all of it has now been uploaded! Not available to everyone, but the story is done–that freaks me out for some reason.
For those reading who missed the earlier bit, start here: http://sailortwain.com/blog/2010/01/15/sailortwain-001/ and be prepared to spend a lot of time.
I’m already looking forward to spending some rainy day reading the whole Twain saga at one sitting. And then going through again, more slowly, reading the comments. I’ll probably buy the book when available as well, just to thank him for the story.
You caught me–I’m re-reading the whole thing now! And yes, will do so again with comments, and will likely buy a copy. Something that brings that much pleasure is worth paying for.
I have a related question for the kind people on here; is my Prinzmetal’s angina related to the migraines? The migraines started becoming more frequent fiteen years ago, at around the time that the angina was becoming troublesome (obvious heart pain instead of something mild enough to be dismissed as indigestion).
Some history: I have congenital prosopagnosia, so I wouldn’t notice that as a migraine symptom. But I often have aura-without-headache (sometimes by noticing the very early changes and getting the meds into myself quickly). The aura can be olfactory and auditory hallucinations as well as/instead of visual ones. Also aphasia, hemiplegia and, occasionally, total paralysis. One time I even forgot that my right hand side existed (which was weird…). After I had gone to bed with a hemiplegic migraine and woke up feeling better, my husband brought me a meal on a tray. After a while, he pointed out that I was having difficulty eating with just the fork in my left hand and I wondered what the problem was.
For the last couple of years I have been taking one Dolased tablet (codeine phosphate 10mg/paracetamol 500mg/doxylamine succinate 5mg) twice a day (with my morning and evening meds) and that has helped largely prevent the head pain and reduce the frequency of other neurological symptoms to around weekly and mostly mild (e.g. stammering and minor vocabulary loss instead of total aphasia; balance problems instead of paralysis; everything being bright and sparkly instead of vision loss). The safe dose is up to eight tablets in 24 hours, so by taking two a day I am well within the limits and can take more if the symptoms break through.
The cracked window effect is classic visual migraine.
I used to get what were diagnosed as migraines … the most common visual effect was a depression in the ground in front of me, as if there were a dip in the grass or even sidewalks.
It made walking difficult, because I never could tell if it was real or not.
Aren’t y’all glad we live in an age where this is not seen as a symptom of possession, and where cures are more than prayer and/or exorcism?
Amen, brother! ;-)
After 40 years of cluster headaches, one day I had a visual migraine instead and it wasn’t followed by pain. No pain at all. I still have visual migraines but I’m almost happy to see them, since they’re SO much better than crushing pain. Is this a new phenomenon for you? If so, perhaps it signifies the start of a change for the better.
As a child, my migraines were intense and started with a visual lack of a focal point…. in fact I couldn’t see the point of focus, it was blanked out. Together with the electrical zig-zag flashes running across the top of my vision they provided the impetus to learn to get to a completely dark and quiet room. If I could actually get to sleep, the searing white hot pain wouldn’t hit, but on awakening I would feel like my brain was physically bruised and would hurt if I shook my head from side to side.
Thankfully I don’t seem to get the headaches anymore, but I do get the aural displays sometimes which are still worrisome but they only seem to last ten minutes and just disappear.
Nasty business… I understand/share your pain
I am so sorry. I come from the position of being the person who does not get migraines who married into a family that does.
First I learned how to deal when spouse got a migraine, which was to make him comfortable, put a damp cloth over his eyes, make sure the room dark and remove the children. Now I have two out of three children who get migraines, and the same routine applies.
My youngest got her first migraine just a couple of weeks ago. She was freaked out by the aura, and I had to explain to her that the majority of her brain is devoted to vision. So if there is any abnormality in function, she will see it first. This did seem to comfort her. It also helped her to tell her that her oldest brother’s aura was that everything turned purple.
What did not help was that her oldest brother recently had a complex migraine that sent him to a hospital. This is a migraine that mimics a stroke. A person literally loses use of any language, and their limbs become numb. And if the person has a severe genetic heart anomaly, this means he is automatically suspected of having a stroke, even though he is only twenty three years old. Not a stroke, but a very bad migraine.
I’ve only had sinus headaches due to allergies. Once I found out what caused them I was able to get rid of them with antihistamines and Sudafed. I have never had a real migraine.
Now I am all too familiar with them. I have nursed more migraines than I care to count. My husband used to get them regularly, but that stopped almost twenty years ago. Now it is two of my children. One has a severe genetic heart condition that prohibits the use of most of the most popular medication. Rats!