Aa
Migraine diagnosis at 31
I am a Caucasian male who, at the age of thirty-one, has developed a condition which follows a classic pattern: scintillating scotoma followed by hours of head pains.
The scintillating scotoma presents as a line or filled circle of ever-changing, colored dots (red/green/blue or black/white) OR as an area of my vision that goes black/brown/gray. When I close my eyes, if the dots were present, I still “see” them. Where the dots or dark area presents, the items of the environment which are positioned at that same location vanish. I can take my arm, which I could previously see in another area of my vision, position in into the dotted/dark area and it instantly vanishes. The dotted circle/line or dark area often moves to other locations of my vision field.
After a half hour or longer, pain will develop within my eyes, between my eyes, and in my frontal lobe. This pain can be moderate (though still unpleasant) to debilitating and lasts for hours if not for the rest of the day and night. In fact, when I experienced the first two episodes, when home I washed up and went to bed (before 6:00 pm) as keeping my eyes closed, while not eliminating the discomfort, feels better (more natural) than keeping my eyes open.
Along with the scotoma and/or while my head/eyes ache during the day of or following an episode, my ability to perceive reality becomes jumpy. Before an episode, I can multi-task (e.g. type a letter while listening coherently to a radio program or hold a conversation, place items on a shelf and know the actions and positions of the people around me, etc.). I am unable to perceive all that occurs around me and take longer to complete routine tasks. If something or someone does not have my attention, I honestly do not know it even exists. One can call my name right next to me during this time and I will continue to perform whatever task I was previously doing without interruption.
Through each episode, until my most recent episode, my vision was completely restored the following day (after an episode). The general pain and eye pressure I experience the day after each episode is subdued with one exception: if I move my head suddenly or crouch down (lowering my head below my heart) I experience temporary moderate pain in the front, sides, and/or rear of my head. This pain, too, will disappear the following day (forty-eight hours after the onset of the scintillating scotoma).
This condition developed while I was on a military installation on temporary training orders. After the third episode of the first month, I sought medical attention. The physician assistant ordered that I see an eye specialist, neurologist, get an MRI, and have lab work done. The eye specialist visit, MRI, and lab results all identified me as being healthy. The neurologist diagnosed me with migraines with a prescription for 10 mg Maxalt-MLT.
It’s now been six months since my first “migraine” episode – I can go weeks in-between episodes or just days. When I have an episode, as directed, I usually take a Maxalt-MLT tablet within ten minutes of identifying the obscured vision. In doing so, my neurologist (and I so far) believe that the full force of the migraine will be averted, i.e. that the head pain will be subdued. If I am able to take the tablet within the first ten minutes, the pain and eye pressure does not seem to be as debilitating. I continue to have “brain freezes” and sore eyes the next day – especially from sudden head movements or lowering my head too low, but I can continue to function normally without any jumping of my mental aptitudes.
What’s scary about this condition is that I can find no common cause which triggers it. Moving from dark to light areas (or vice versa), tracking food choices, even monitoring the time my eyes stare at a screen each day don’t seem to relate to when a migraine will develop. So far, episodes have been experienced while I was staring at a computer screen (at my military employer on orders), sitting in a chair (at my military apartment while on orders), preparing breakfast (in my military apartment while on orders), attending a manufacturer training class (while at the manufacturer facility), baking cookies and making dinner at home, driving home from my ANG home base, stocking shelves at a civilian employer, and watching tv sitting in a chair at home. The episode while on the road brings the most pause – I could only perceive what my immediate focus was on, which was the road directly in front of me. Cars traveling in the opposite direction on the divided four-lane freeway appeared as nothing more than changes in light intensity (being after 6:00 pm, all cars had their headlights on). On smaller two-lane roads, however, with vehicles in the other lane going in the opposite direction, I didn’t see ANY of them (not even the lights from their headlights).
My most recent episode occurred nine days ago while I was wasting but twenty minutes before voluntarily calling it a day at 8:00 pm. At 7:48 pm, a part of my vision transformed into a line of colored dots. I elected to wash up and retire (as I had intended to do) but without taking the Maxalt-MLT. The line of scintillating scotoma moved from the left to the right side of my vision field; wherever it went, I “saw” it whether my eyes were open or closed. By 8:05 pm, I was in bed. I kept my eyes closed as much as possible – praying that I would fall asleep as the eye pressure and pain between my eyes intensified. I just laid in bed, uncomfortable. For a brief moment, I decided to open my eyes to check the clock – it read 10:15 pm. After again closing my eyes, apart from the constant pain, I don’t recall anything until I woke up the next morning to the predictable eye soreness and sudden activity/head lowering pains. I went to work where, beginning at 8:00 am, the eye pain intensified while I was stocking shelves. Around that time, the entire periphery of my vision field became cloudy and my mental senses became slowed/jumpy. I was unable to function at my usual pace; rotating stock, locating back-stock, moving carts, and throwing out garbage/cardboard became a struggle. My vision and mental perception aptitude were not restored until 11:23 am when I, again, experienced only the normal day-after eye soreness and sudden activity/head lowering pains.
I offer this tale because, given my young age, I am worried that the sudden bouts of blindness I experience will lead to my premature death. At my military medical clinic, I consult with an ANG physician who advises me to record each episode (what doing, how long, vision status). Over six months I have experienced eight or nine (depending on whether my most recent episode can be considered one or two separate incidents) episodes.
Am I truly a migraine sufferer or is there another (perhaps rare) condition which presents itself at mid-life as scintillating scotoma followed by hours of head pains? My maternal grandmother mentioned that she suffered from migraines early in life but that they went away at some point. Her migraines did not include vision obstruction (scintillating scotoma).
Thank you for your attention, thoughts, and advice.
The scintillating scotoma presents as a line or filled circle of ever-changing, colored dots (red/green/blue or black/white) OR as an area of my vision that goes black/brown/gray. When I close my eyes, if the dots were present, I still “see” them. Where the dots or dark area presents, the items of the environment which are positioned at that same location vanish. I can take my arm, which I could previously see in another area of my vision, position in into the dotted/dark area and it instantly vanishes. The dotted circle/line or dark area often moves to other locations of my vision field.
After a half hour or longer, pain will develop within my eyes, between my eyes, and in my frontal lobe. This pain can be moderate (though still unpleasant) to debilitating and lasts for hours if not for the rest of the day and night. In fact, when I experienced the first two episodes, when home I washed up and went to bed (before 6:00 pm) as keeping my eyes closed, while not eliminating the discomfort, feels better (more natural) than keeping my eyes open.
Along with the scotoma and/or while my head/eyes ache during the day of or following an episode, my ability to perceive reality becomes jumpy. Before an episode, I can multi-task (e.g. type a letter while listening coherently to a radio program or hold a conversation, place items on a shelf and know the actions and positions of the people around me, etc.). I am unable to perceive all that occurs around me and take longer to complete routine tasks. If something or someone does not have my attention, I honestly do not know it even exists. One can call my name right next to me during this time and I will continue to perform whatever task I was previously doing without interruption.
Through each episode, until my most recent episode, my vision was completely restored the following day (after an episode). The general pain and eye pressure I experience the day after each episode is subdued with one exception: if I move my head suddenly or crouch down (lowering my head below my heart) I experience temporary moderate pain in the front, sides, and/or rear of my head. This pain, too, will disappear the following day (forty-eight hours after the onset of the scintillating scotoma).
This condition developed while I was on a military installation on temporary training orders. After the third episode of the first month, I sought medical attention. The physician assistant ordered that I see an eye specialist, neurologist, get an MRI, and have lab work done. The eye specialist visit, MRI, and lab results all identified me as being healthy. The neurologist diagnosed me with migraines with a prescription for 10 mg Maxalt-MLT.
It’s now been six months since my first “migraine” episode – I can go weeks in-between episodes or just days. When I have an episode, as directed, I usually take a Maxalt-MLT tablet within ten minutes of identifying the obscured vision. In doing so, my neurologist (and I so far) believe that the full force of the migraine will be averted, i.e. that the head pain will be subdued. If I am able to take the tablet within the first ten minutes, the pain and eye pressure does not seem to be as debilitating. I continue to have “brain freezes” and sore eyes the next day – especially from sudden head movements or lowering my head too low, but I can continue to function normally without any jumping of my mental aptitudes.
What’s scary about this condition is that I can find no common cause which triggers it. Moving from dark to light areas (or vice versa), tracking food choices, even monitoring the time my eyes stare at a screen each day don’t seem to relate to when a migraine will develop. So far, episodes have been experienced while I was staring at a computer screen (at my military employer on orders), sitting in a chair (at my military apartment while on orders), preparing breakfast (in my military apartment while on orders), attending a manufacturer training class (while at the manufacturer facility), baking cookies and making dinner at home, driving home from my ANG home base, stocking shelves at a civilian employer, and watching tv sitting in a chair at home. The episode while on the road brings the most pause – I could only perceive what my immediate focus was on, which was the road directly in front of me. Cars traveling in the opposite direction on the divided four-lane freeway appeared as nothing more than changes in light intensity (being after 6:00 pm, all cars had their headlights on). On smaller two-lane roads, however, with vehicles in the other lane going in the opposite direction, I didn’t see ANY of them (not even the lights from their headlights).
My most recent episode occurred nine days ago while I was wasting but twenty minutes before voluntarily calling it a day at 8:00 pm. At 7:48 pm, a part of my vision transformed into a line of colored dots. I elected to wash up and retire (as I had intended to do) but without taking the Maxalt-MLT. The line of scintillating scotoma moved from the left to the right side of my vision field; wherever it went, I “saw” it whether my eyes were open or closed. By 8:05 pm, I was in bed. I kept my eyes closed as much as possible – praying that I would fall asleep as the eye pressure and pain between my eyes intensified. I just laid in bed, uncomfortable. For a brief moment, I decided to open my eyes to check the clock – it read 10:15 pm. After again closing my eyes, apart from the constant pain, I don’t recall anything until I woke up the next morning to the predictable eye soreness and sudden activity/head lowering pains. I went to work where, beginning at 8:00 am, the eye pain intensified while I was stocking shelves. Around that time, the entire periphery of my vision field became cloudy and my mental senses became slowed/jumpy. I was unable to function at my usual pace; rotating stock, locating back-stock, moving carts, and throwing out garbage/cardboard became a struggle. My vision and mental perception aptitude were not restored until 11:23 am when I, again, experienced only the normal day-after eye soreness and sudden activity/head lowering pains.
I offer this tale because, given my young age, I am worried that the sudden bouts of blindness I experience will lead to my premature death. At my military medical clinic, I consult with an ANG physician who advises me to record each episode (what doing, how long, vision status). Over six months I have experienced eight or nine (depending on whether my most recent episode can be considered one or two separate incidents) episodes.
Am I truly a migraine sufferer or is there another (perhaps rare) condition which presents itself at mid-life as scintillating scotoma followed by hours of head pains? My maternal grandmother mentioned that she suffered from migraines early in life but that they went away at some point. Her migraines did not include vision obstruction (scintillating scotoma).
Thank you for your attention, thoughts, and advice.
Another migraine resource online (Dr. Weil) mentions the following food related triggers for migraines:
"Typical food triggers include aged cheeses and processed meats (particularly pepperoni and hot dogs); peanuts; bread and crackers containing cheese as well as any strong-flavored cheeses; broad beans, peas, and lentils; and beverages containing caffeine and chocolate. Wine is another culprit (red is usually more problematic than white). Fermented foods including soy sauce and miso have been implicated, as have some fish including sardines, anchovies, and pickled herring. Other foods that have been linked to migraines include avocados, bananas, citrus fruits, figs, raisins, red plums, and raspberries."
During a three consecutive day stretch in which Day 1 featured my most recent attack, I ate exactly the same foods all three days.
Question: Is there any documented research on a "delay factor" between consuming a "triggering food" and the onset of the aura/migraine? Given my experience, it seems plausible that none of the foods I consumed on Day 1 triggered my migraine that day. Must a offending substance first be digested and sent to the vasculature around the brain before causing the vessels to dilate twenty-four hours later?
Thank you.
"Typical food triggers include aged cheeses and processed meats (particularly pepperoni and hot dogs); peanuts; bread and crackers containing cheese as well as any strong-flavored cheeses; broad beans, peas, and lentils; and beverages containing caffeine and chocolate. Wine is another culprit (red is usually more problematic than white). Fermented foods including soy sauce and miso have been implicated, as have some fish including sardines, anchovies, and pickled herring. Other foods that have been linked to migraines include avocados, bananas, citrus fruits, figs, raisins, red plums, and raspberries."
During a three consecutive day stretch in which Day 1 featured my most recent attack, I ate exactly the same foods all three days.
Question: Is there any documented research on a "delay factor" between consuming a "triggering food" and the onset of the aura/migraine? Given my experience, it seems plausible that none of the foods I consumed on Day 1 triggered my migraine that day. Must a offending substance first be digested and sent to the vasculature around the brain before causing the vessels to dilate twenty-four hours later?
Thank you.
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