Visual migraine

[scw5142]

Hi, I am a 21 year old male.  3 weeks and 2 days ago while taking finals exams and the day after my grandmother passed away I got a weird sensation in my head while I was taking a final where it felt as though I was going to pass out, I was dizzy and my vision was flashing.  I went to a doctor and was told I was having a migraine aura. Other symptoms I have had were heart palpitations, fatigue and trembling. The symptoms continued and I went to physician, eye doctor and a neurologist who all said I am having a visual migraine or a migraine variant. I had an MRI which came back normal and am having an EEG tomorrow.  The symptoms are minimized with prescribed xanax but have not gone away for now over 3 weeks.  The worst symptom is the vision flashing because it constant, persistent, and noticeable.  I also have costochrondritis, is there any way that can be connected to this? Mainly my question is, is it possible for a visual migraine to last this long or is this even a visual migraine? If it is what can I do to make it go away? Thanks for any help.

[SLadylani]

Scott,
Here's some information I can give you:
Headaches with neck pain are sometimes referred to as cervicogenic headaches or muscle contraction headaches. Stress and tension are both contributors to these types of migraines and neck pain.  Post-traumatic vertigo refers to dizziness that follows a neck or head injury. Patients with head or neck injury may also have loud and disturbing tinnitus.
These headaches may also be brought on by an injury to the head or neck area that was not treated adequately---or at all. The neck is intimately connected with headaches, and can cause either referred pain to the head, primary muscle contraction/tension headaches or can trigger migraines. The neck can also result in causing dizziness or vertigo as there are a lot of sensory nerves there controlling balance, and which way your head and eyes are turning, etc. Diagnosis is made by a neurologist, who will ask a series of questions about the types, number, and severity of you headaches. When neck pain is reported, diseases such as meningitis need to be ruled out. Tests such as a CT (cat scan) or MRI (magnetic resonance imaging) may be used to determine if there may be something more serious involved. Physical treatment like massage therapy or physical therapy is helpful to some people. Others may choose to see a chiropractor to help loosen muscles and realign the body. In addition, acupuncture and acupressure are alternative treatments that many people use. Xrays can only show so much of what's going on. Is the doctor that did the Xrays a chiropractor? Often Chiropractors can exaggerate what's going on, or miss the real picture-as well intentioned as they are. Considering the history and severity of your symptoms, and the visual probllems involved, this neck misalignment could be the sign of something more-such as nerve damage. What I definitely suggest, if you have not done so yet, is you go back to your neurologist with the neck Xrays and present the idea of a MRI of the neck. That could show a lot more of what's going on with your neck and if in fact your neck is the cause of you visual symptoms and migraines. Neck misalignments can be common in people, especially with aging, even if you're only in your thirties! So there is a good chance this may not be the cause of your symptoms, but it's definitely worth further investigation. I'm so glad that you're still being persistent and seeking alternative methods of pain and symptoms releif, and not giving up. Topamax can be a wonderful drug for migraine prevention-migraines of multiple types. It does take time to see full effects and dosage varries for each person. I myself take it for migraines and am on a somewhat high dose of 200mg daily. I do have to keep titering up once in a while, but it works. So to summarize all this, what I suggest is to call your neurologist and schedule an appointment. When you see him/her have copies of your xray faxed over or ready at hand. Emphasize how your symptoms are still dramatically effecting your life and you're still struggling to resolve them. Think back at the time the symtoms started-did anything happen to your head/neck? I know you were studying for exams, was your head hung over books all day every day and not in proper alignment? In the mean time, I would continue to do what works for you. This does sound like it's at least partly stress/tension related, so if you have the time/luxuray, continue massages and if you'd like, investigate in alternative medicine such as chiropractory or acupunture. I would suggest living as much of a stress free life as you can, avoidng stressful activities and practicing relaxation, or perhaps meditation. Have you tried journaling? Do you have a good support group such as freind/family that you can lean on right now? Therapy? As usual, continue to let me know how you're doing as I really do care and want you to get better, as you've been struggling for some time now. I hope whatever this neck thing turns out to be, you get the care and treatment you need, and continue to feel better each day. I'm sending good luck and my best wishes your way. Take care of yourself please :)

Sara RN

[scw5142]

Hey Sara,
I know it's been a while since I wrote to you but I just wanted to keep you updated.   Believe it or not the symptoms have not fully gone away yet.  These are the constant dizziness and the constant flashing in my vision.  The symptoms have got better over the past few weeks with the medicine I was prescribed, Topamax, but have not gone away.  I have decided to stop taking the xanex.  I recently was told to go to a massage therapist for all the tension in my chest and neck muscles that have devolved from either anxiety or whatever else is causing this and it has really helped.  I did however get x-rays of my neck today and it was found that I have a misalignment of my neck.  The doctor said that this was a possible cause of the symptoms I was experiencing and through rehab it was reversible.  I was wondering if you had any information on this subject in regards to migraines specifically with visual symptoms and dizziness and if a misalignment of my neck can lead to the symptoms I have been going through.  As always I appreciate any help you can offer.  
Scott

[SLadylani]

Hey Scott, thanks for giving me some more details, that helps me understand things more. I'm so glad you're still working with doctors in your area. I take Topamax. I take it for chronic migraines. It's off-label use is migraine prevention, which is not what you have, but if the doctor who gave it to you found it worked for one of his patients, then it's worth giving it a shot, as long as you don't have to pay for it as it's expensive! About the blood pressure, the reason I asked was that high blood pressure can cause visual changes. If you use to tend to run on the low side, and now your running high, that could be a huge leap for your body. However, visual symptoms typically only happen with very high blood pressure and these symptoms usually occur with a painfull headache as well, so I'm reluctant to suggest this may be the cause for your symptoms. If this isn't just a long ocular migraine, possible causes to look into are inflammation of large arteries to the eye (similar to high blood pressure symptoms) or complication with the optic nerve. But again, I think we're both onto something when we realize that stress is a crucial component in this. I am glad your heart rates back to normal. I also think getting tested for Lyme is a good idea, just to get that off the table. I do think a type of emotional breakdown or psychological and emotional shock could have brought this on. It could have been you hit your breaking point with stress. A part of this could be your body's way of telling you to slow down, grieve, and take a break. Ever heard of a somatoformin disorder? That's when your body creates real symptoms that aren't medically explainable. It might be a good idea with all this stress going on to check in with a therapist or support group, or whatever suites you. You never know what you may learn about yourself and what's going on. You're in limbo right now, but there's plenty of hope, in my oppinion. You're actively seeking help and getting more oppinions and more tests and not just allowing these symptoms to rule your life. You're being your own advocate, and that's the nicest and best thing you can do for yourself right now. I truly hope you get some answers soon, and I am sending good wishes your way. Good luck at your next doctor's appointment, and let me know how it goes!

Sara RN

[scw5142]

Hey Sara.  I have been working through the doctors in my school and also calling my neurologist at home.  He finally prescribed me medicine, topamax, which he says he has seen one other patient have a visual migraine this long and he gave this prescription to him and the visual effects were gone within a few days.  I have just started taking them and have noticed improvement in my vision.  To be exact with what I am experiencing, I have no actual headache or pain.  Occasionally I will get a migraine that will last around 3 hours on one side of my head; this has happened 3 times over the 1 month and 1 week, but other than that there is no pain.  I do feel like my head is pulsing but there is no pain.  The visual effects are the main problem and they are constant, they never have fully gone away. The balance issues have been somewhat minimized but also have not gone away.  I have found an ENT doctor and am going next week.  The xanax minimizes the symptoms for a few hours, but it seems to me that I have having a persistent aura.  I have always had good blood pressure, but I know my doctor said it was a little high when I went in but he did not seem too worried. I will get it checked again next time I go to my college health center.  My heart rate at least standing has returned to normal almost, definitely below 100 now.  So I think, and it seems that you may agree that this could be a visual migraine induced and kept on by stress and anxiety first from emotional stress and then from anxiety of the visual migraine itself.  Let me know if you think this is possible.  I also will get tested for Lyme, I too looked into this and it could be possible.  I can't thank you enough for listening to me and helping me through this tough time in my life.

Scott

[SLadylani]

Hi Scott, I'm so sorry to hear this is still going on. Do you not have any doctors in your area, or does your doctor in your area know about the problem? Can you describe the characteristics of your headaches as best you can to me? You never really stated if they are painful or not, are they? If so, what type of pain would you describe it as? If you're in pain, tachycardia can be from the fact that your body is responding to the fact that you've been suffering for a while now; it's a human physiological response to pain. But if not, this is something to look into. Another thing, do you remember how your blood pressure has been when you went to the doctors? Last thing, it's been several weeks now, so I'm thinking a couple of things. First, yes, there are cases of ocual migraines that have lasted this long, but this definitely isn't typical, and I'm not sure you completely fit this diagnosis, particularly if you have not experienced dramatic releif with medications. Second, being that this happened so closely at such a stressful time in your life, this could be related, possibly a "psychotic" or stressed-induced episode, which is why medications alone aren't working. Lastly, is there any chance you could have been bitten by a tic? Do a quick reasearch on the ocular symptoms of Lyme disease and see if it fits you. I do think there is something else to this, and I do think it best to be in touch with doctors, any doctors, that way at least someone can be tracking your symptoms and at best may offer different oppinions by physical exam and try new medications. Take care of yourself, especially now that your back at school, and let me know how things are going. I'm really sending goog thoughts your way.

Sara RN

[scw5142]

Hi again, I have started to feel alittle better, but still not quite normal.  I am still seeing flashing in my vision 24/7 and have minor balance problems.  The main problem now is that I went back to college so I am no where near my doctors and I have no new medicince and the problem has not been fixed.  Other things I have noticed during this 1 month and 1 week episode is that my heart rate is significantly faster at all times of the day than it was before this started.  My standing HR is probably around 97-100 and when I go run on a treadmill it gets up to 165-170 when I am not exerting a ton of energy.  I guess my next question is if this is still a visual migraine or is it something else?  And if it is still a migraine, have you ever heard of one that has lasted this long?  As always I appreciate your response and help.  Scott

[SLadylani]

Scott, I'm glad the EEG was normal and I'm glad you've identified some triggers! Let me know how your next doctors appointment goes and how you're doing :)

Sara RN

[scw5142]

I got the EEG results back which were also normal.  I think I have indentified some of my triggers as well, so I have made some progress and furthermore the symptoms seem to be finally diminishing, very slowly.  I will try and be more proactive and get the proper migraine medication from my doctor to return to normal health, I really appreciate your help during this process.

Scott

[buggysmommy]

I too have had occular migranes and Severe headaches for years. It is  like a tension headache that turns into a migrane. I have had them turn so violent I will vomit (which makes them worse).I become just miserble & have to sleep it off. I do get relief from xanax with the headaches that are like that.

I tend to hold alot of tension in my neck and shoulders. I have found that self massage (deep tissue) REALLY helps alot! If you lay on the floor with two tennis balls at the base of your skull for 10-15 min, the natural traction will allow those muscles relax. You can also roll up a towel and lay with it. I have some thereapy balls that look like dryer balls that I bought from my physical therapy department you can also buy them at OPTP .com Ice helps mine also. Do some resarch on Trigger-Point therapy or self-massage to get an understanding on how to do it (very simple) I have dealt with these headaches since I was 13 or 14. I hope this helps!

[SLadylani]

Dear Scott,

There are defininitely medications for this, so don't worry, you don't have to live like this forever! For tension migraines, muscle relaxers, such as soma or flexeril, may be a good start. Midrin might be a good start, although there are many drugs your doctors may want to try. This combination medication is used to relieve tension-type headaches and abort Migraine attacks. The brand name medication is discontinued, but generic acetaminophen. isometheptene and dichloralphenazone is available. Then you could also go as far as a injection, Sumatriptan is used to treat migraines and cluster headaches. It helps to relieve pain and other symptoms of migraines/headaches including sensitivity to light or sound, nausea, and vomiting. There are so many other migraine medications, I couldn't list them all. There are meds you take daily to prevent the migraines, and meds you take promptly when symptoms begin to stop an attack. Your doctor may give you both. What I suggest is definitely being an advocate for yourself and letting your doctors know you can't live normally with these symptoms and need something for them. Do you have pain with your migraines? If so, general pain killers and muscle relaxers may do for now. But for now I suggest checking out your daily routine and see if there is anything that correlates with the migraines. Does it get worse after eating something, exercising, etc. Once you've identified that, then you can try to avoid it or try new things. Definitely keep us posted on the EEG results and how you're doing, and I trully hope you have as much releif as possible soon :)

Sara RN

[scw5142]

I am feeling better at times through that day, but at certian point, like when I wake up and around mid day, I am at my worst.  The EGG results were supposed to be ready today but my doctor said they will not be ready until Wednesday.  They also said that if there was a problem with the test I would have know about it by now.  I was wondering if there was actual medicine for visual migraines or a migraine of this type such as a tension migraine you described.  I have tried to reduce my stress, and basically return to my daily life such as regular exercise and work, but the symptoms have not gone away.  Also even more recently I have gotten actual migraines on one side of my head lasting about 4 hours the previous 3 nights. Is there anything else I can do or should I just stay with the xanax and avoid stress?  I appreciate your help.

Scott

[scw5142]

I am feeling better at times through that day, but at certian point, like when I wake up and around mid day, I am at my worst.  The EGG results were supposed to be ready today but my doctor said they will not be ready until Wednesday.  They also said that if there was a problem with the test I would have know about it by now.  I was wondering if there was actual medicine for visual migraines or a migraine of this type such as a tension migraine you described.  I have tried to reduce my stress, and basically return to my daily life such as regular exercise and work, but the symptoms have not gone away.  Also even more recently I have gotten actual migraines on one side of my head lasting about 4 hours the previous 3 nights. Is there anything else I can do or should I just stay with the xanax and avoid stress?  I appreciate your help.

Scott

[SLadylani]

Your welcome Scott, and I trully do hope you get some relief soon. I am glad your doctors are taking good caree of you :) Keep us posted.

Sara RN

[Dr Santos]

Hi Scott,
How are you? What was the result of the EEG? IT is good that the MRI was normal, which helps rule out organic causes. I agree with  Sara, that ocular migraines may present with your symptoms. Continue with your medications and try to avoid the triggers that may be causing the attacks. Sometimes, another primary headache- tension headache, may occur together with migraine, especially if you have had emotional stress for the past weeks. Try to rest, relax and manage the stress at this point. Take care and do keep us posted.

[scw5142]

Thanks for the response Sara.  I felt same way that a visual disturbance couldn't last this long from a migraine, and recently the neurologist told me that since it is always evident that there is something wrong because I can see it, it brings more stress which may keep it going.  I will continue to keep low stress and take some medicine, I have over the past few days started to feel better.  I really appreciate response and your help.

Thanks,
Scott

[SLadylani]

Hi, I am Sara, the RN. I wanted to get back to you. First, the easy stuff. The costcocondritis I think would be unrelated as that is inflammation of the cartalages in between your ribs. You might habe had this for a while and stress brought this  up.Next, I think its good that you're getting an EEG, but I think that will be negative as well, as an EEG tests for seizure disorders such as epilepsy, and this doesn't sounmd typical of one of those. Third, as I was reading your post, what stood out to me is your symptoms seemed to be brought on by stress. What coincides with that is that Xanax, and anti-anxiety agent, helps to relieve some of your symptoms. So now to get to what you do have, and how you can feel better. I researched visual migraines, and trully your symptoms coincide with a visual migraine, also known as an ocular migraine. The only difference is most migraines last for seconds, to hours, to days. There are rare cases howver where symptoms can last longer than that. Also, you get physical symptoms, such as dizziness and palpitations. I think this matches up with the anxiety. Basically, I think your symptoms might have been induced by anxiety, and thus continue to be triggered by stress. So what I recommend is keeping your environment on a low stress level as much as you can, and continue to work clsoely with your doctors. It sounds like they are taking good care of you. I wish you the best, and hope you can find releif soon!

Sara RN

[SLadylani]

Hi, I'm Sara, I'm an RN. I try to get all my questions answered by the end of the night, but I'm experiencing symptoms myself. If you do not get any replies by tomorrow, please repost and hopefully someone if not myself will get back to you! I just usually try to not let people wait this long :)

Sara RN