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Am I Having A Migraine

Should I Be Concerned About Ocular Migraines

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Q: I recently found out by looking on the Web that my symptoms point to ocular migraines. I have also discovered that flashing lights sometimes bring these on. I am an intensive care unit nurse who believes in not running to doctors for every little thing, but should I be concerned?

Dr. Jerry W. Swanson responds:

Not necessarily, but here’s what you should know. Ocular is a term that usually refers to a condition known as migraine visual aura, which involves episodes of passing visual disturbances, such as bright spots, affecting both eyes. Visual aura usually precedes a migraine . However, it may also occur during a headache. In some cases, as with ocular migraine, people experience the symptoms of visual aura without getting a headache. The symptoms of an aura usually begin slowly and last 15 to 30 minutes, although they sometimes persist for up to an hour.

Often, the symptoms of ocular migraine begin near the center of vision as either a bright spot or area of visual loss that spreads to involve one-quarter or one-half of the visual field. Zigzag lines or other shapes may also appear. For some people, these shapes resemble the walls of a medieval fortress. In fact, the term “fortification spectrum” is used by neurologists to describe it.

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Understanding What Causes Headaches And Finding Treatments To Relieve The Pain

Nearly everyone has had headache pain, and most of us have had it many times. A minor headache is little more than a nuisance that’s relieved by an over-the-counter pain reliever, some food or coffee, or a short rest. But if your headache is severe or unusual, you might worry about stroke, a tumor, or a blood clot. Fortunately, such problems are rare. Still, you should know;when a headache needs urgent care;and how to control the vast majority of headaches that are not threatening to your health.

Is My Headache A Migraine

There are 300 different types of headaches, says Lay. And they each have distinguishing characteristics. Sinus headaches are caused by an infection or allergic reaction thats creating inflammation in the sinus and triggering pain and pressure in the cheeks and head. Cluster headaches typically occur on just one side of the head, around the eye, and are incredibly painful. There are also exertional headaches that can be triggered by a bad cough or even a fantastically good orgasm.

Tension headaches are the most common, characterized by a dull ache on one or both sides of your head, and/or tightening in the back of your neck. A walk outdoors, a round of meditation or some over-the-counter medication usually takes care of them. By and large, theyre not a big deal, says Lay. There is a subset of this headache type called a chronic daily tension headache, which obviously is more disabling because it occurs every day, but by definition a tension headache is rarely bothersome and often doesnt even need treatment, she says.

The second most common type of headache comes with a migraine attack, and as every person living with migraine knows, its so much more than just a really bad headache. In fact, a headache is considered just one aspect of a migraine attack. With migraine, there are neurobiological brain changes going on for 12 to 24 hours before the headache arrives, says Lay.

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Are There Different Kinds Of Migraine

Yes, there are many forms of migraine. The two forms seen most often are migraine with aura and migraine without aura.

Migraine with aura .;With a migraine with aura, a person might have these sensory symptoms 10 to 30 minutes before an attack:

  • Seeing flashing lights, zigzag lines, or blind spots
  • Numbness or tingling in the face or hands
  • Disturbed sense of smell, taste, or touch
  • Feeling mentally “fuzzy”

Only one in five people who get migraine experience an aura. Women have this form of migraine less often than men.

Migraine without aura .;With this form of migraine, a person does not have an aura but has all the other features of an attack.

What Happens During A Migraine

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Every migraine begins differently. Sometimes people get a warning that a migraine is on its way. A few hours or even days before the actual headache, people might feel funny or “not right. They might crave different foods, or feel thirsty, irritable, tired, or even full of energy. This is called a “premonition.”

Some people get auras. These are neurological symptoms that start just before the headache and last up to an hour. An aura is different in every person, but it often affects vision. For example, a person might:

  • have blurred vision
  • see spots, colored balls, jagged lines, or bright flashing lights
  • smell a certain odor
  • feel tingling in a part of their face

Once the headache starts, light, smell, or sound may bother people with migraines or make them feel worse. Sometimes, if they try to continue with their usual routine, they may become nauseated and vomit. Often the pain begins only on one side of the head, but it might eventually affect both sides. Trying to do physical activities can make the pain worse.

Most migraines last from 30 minutes to several hours; some can last a couple of days.

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I Get Migraines Right Before My Period Could They Be Related To My Menstrual Cycle

More than half of migraines in women occur right before, during, or after a woman has her period. This often is called “menstrual migraine.” But, just a small fraction of women who have migraine around their period only have migraine at this time. Most have migraine headaches at other times of the month as well.

How the menstrual cycle and migraine are linked is still unclear. We know that just before the cycle begins, levels of the female hormones, estrogen and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals in the brain that affect a woman’s pain sensation.

Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.

When Migraine Mimics Stroke

The symptoms of some types of migraine can mimic stroke, such as hemiplegic migraine where there is weakness down one side.

Migraine auras can be confused with transient ischaemic attack , where someone has stroke symptoms that pass in a short time. For instance, a migraine with only a visual aura but no headache may be mistaken for TIA.

Like a stroke, a migraine can be sudden and can lead to mild confusion. However, migraine aura symptoms tend to develop relatively slowly and then spread and intensify, while the symptoms of a TIA or stroke are sudden.;

Migraine can sometimes be mistaken for a stroke caused by bleeding on the brain, called a subarachnoid haemorrhage , which is often characterised by a sudden, very severe headache. Unlike SAH, migraine headache is usually one-sided and throbbing, slow to come on and lasts for a shorter period of time. Vomiting usually starts after a migraine headache starts, but is likely to happen at the same time as headache during a SAH. Patients with a SAH also develop neck stiffness, which is uncommon during a migraine attack.;

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When To Get Medical Advice

You should see a GP if you have frequent or severe migraine symptoms.

Simple painkillers, such as paracetamol or ibuprofen, can be effective for migraine.

Try not to use the maximum dosage of painkillers on a regular or frequent basis as this could make it harder to treat headaches over time.

You should also make an appointment to see a GP if you have frequent migraines , even if they can be controlled with medicines, as you may benefit from preventative treatment.

You should call 999 for an ambulance immediately if you or someone you’re with experiences:

  • paralysis or weakness in 1 or both arms or 1 side of the face
  • slurred or garbled speech
  • a sudden agonising headache resulting in a severe pain unlike anything experienced before
  • headache along with a high temperature , stiff neck, mental confusion, seizures, double vision and a rash

These symptoms may be a sign of a more serious condition, such as a stroke or meningitis, and should be assessed by a doctor as soon as possible.

Common Causes Of Migraines

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Doctors arenât totally sure what causes migraineÂ;headaches, but they think imbalances in certainÂ;brainÂ;chemicals may play a role.

The trigeminal nerve in your head runs yourÂ;eyesÂ;andÂ;mouth. It also helps you feel sensations in your face and is a major pathway for pain. Your levels of a chemical called serotonin may fall at the start of a migraine, and this nerve can release chemicals called neurotransmitters that travel to yourÂ;brainÂ;andÂ;cause pain.

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Weakness On One Side Of The Body

When an arm goes limp, it can be a sign of a migraine.

Some people experience muscle weakness on one side of the body before a migraine attack. This can also be a sign of a stroke, however, so consult a doctor to rule out any other causes.

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Am I Having A Migraine Common Migraine Symptoms And When To See A Doctor

How do I know if Im having a migraine? How many migraines should I experience before I see a doctor? How bad do the migraines need to be to warrant medical attention?

These are questions I hear frequently from patients and, unfortunately, there is not a one size fits all answer. The severity, frequency and triggers of a migraine headache can drastically vary from person to person, making it hard to determine when its time to see a doctor. Use my guide below to help identify if your headache could be a migraine and, based on your headache patterns, if medical attention could be beneficial.

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Recovery Or Postdrome Stage

This is the final stage of an attack, and it can take hours or days for a drained, fatigued or hangover type feeling to disappear. Symptoms can be similar to those of the first stage . Often, they mirror these symptoms. For example, if you lost your appetite at the beginning of the attack, you might be very hungry now. If you were tired, you might feel full of energy.

Being aware of the different stages of the migraine attack can be helpful. It can help you prepare for an attack, get a diagnosis and decide when to take acute treatment, such as painkillers or adapt your activities.

It is useful to have a rescue treatment plan for when attacks occur. This may include painkillers such as a triptan, a NSAID or paracetamol. It often also includes anti-sickness medication.

For other people, being aware of the stages and symptoms of a migraine attack can help their understanding. It may also help with the frustration and lack of understanding people often face around migraine, especially at work and in education.

What Is The Prognosis For People With Migraines

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Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.

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Preventative Medication And Therapies

If you experience frequent migraines, your GP might discuss preventative medication options with you.

It is important to note that preventatives for migraines are not pain medication, but help to reduce the number of migraines. They take time to work, so the minimum time period required may be three to six months. Contact your GP or specialist for further information. All of these treatments have their advantages and disadvantages and some of the medications might not be suitable for everybody.

You might find that this medication reduces the frequency and severity of your attacks but does not stop them completely. You will need to continue your other migraine treatments when you experience an attack.

National Institute for Health and Care Excellence recommends that GPs and specialists should consider the following drugs and therapies if they think you might benefit from preventative treatment:

Beta blocking drugs

These drugs are traditionally used to treat angina and high blood pressure. It has been found that certain beta-blockers prevent migraine attacks. Beta-blockers are unsuitable for people with certain conditions.


This drug is typically prescribed for the treatment of epilepsy but has also been found to help reduce the frequency of migraines. Again, it is not suitable for everyone. In particular, women who are pregnant or thinking about getting pregnant should be advised of the associated side effects.



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What Causes Migraine

Scientists and doctors think migraine is the result of abnormal brain activity affecting nerve signals, chemicals and blood vessels in the brain. We dont know what causes this brain activity, although for many people there is a link to their genes. If you are sensitive to migraine there are certain triggers which can have an impact. These include stress, skipping meals and low blood sugar, alcohol, hormonal changes in women, lack of sleep and the environment you are in .

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Are Migraines Fatal

Most migraines don’t cause lasting harm.

Rarely, you can have a complication called migrainous infarction. That’s when you have a stroke while you’re having a migraine. But there’s no evidence migraine can trigger a stroke.

It’s extremely rare, but a hemiplegic migraine can sometimes lead to a coma or other serious complications.

A very intense headache that starts suddenly can be a sign of another, more serious condition, like a stroke or aneurysm. Get medical help right away if this happens.

How To Get Started

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Before starting an exercise program, its important to check with your doctor. To prevent stress and overexertion, we recommend slowly introducing exercise into your routine. By pacing yourself, preparing for your routine with the right gear and carefully considering your diet, you can help reduce the risk of exercise-induced migraine attacks and get the most out of a workout.

First, make a plan to help you stick to staying active. Set reminders to get moving by adding time to your calendar, putting up sticky notes or setting an alarm. It helps if you aim to make your exercise more convenient by fitting it into your schedule where it works best. Some people prefer morning activities while others prefer after-work exercises. Either way, try to remove barriers to getting active by choosing a convenient location and time to workout.

Before any physical activity, warm up your muscles by stretching or taking a slow-paced walk. Over time, you can build up your tolerance and tackle longer or tougher exercises. But be sure to listen to your body and avoid pushing yourself too hard, as that can trigger a migraine attack.

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Feeling Colder During Migraine

I never thought of hypothermia as a migraine symptom, but I knew several of my attacks came with a sensation of cold. I just could not warm up sometimes. Id be sitting there actually shivering. I didnt have a fever I was just experiencing a cold sensation right to my core. During these attacks, I would switch from ice packs to heat. I would be bundled up with blankets and retreat to my room. This symptom always freaked me out because it was so far from my norm. Needless to say, I was once again relieved to find cases of people suffering from migraine who also were experiencing hypothermia! I immediately felt validated after reading over the cases. I had found that my body temperature issues were not just in my head.

What Are The Symptoms Of A Migraine

Individual migraines are moderate to severe in intensity, often characterized by a throbbing or pounding feeling. Although they are frequently one-sided, they may occur anywhere on the head, neck and face or all over. At their worst, they are typically associated with sensitivity to light, noise and/or smells. Nausea is one of the most common symptoms and it worsens with activity, which often results in patient disability. In many respects, migraines are much like alcohol-related hangovers.

Migraine pain can be felt in the face, where it may be mistaken for sinus headache or in the neck, where it may be mistaken for arthritis or muscle spasm. Complicating the diagnosis of migraine is that the headaches may be accompanied by other “sinus like” symptoms, including watering eyes, nasal congestion and a sense of facial pressure. Most patients who think they have sinus headache in fact have migraines.

In up to 25 percent of patients, the migraine headache pain may be preceded by an aura, a temporary neurological syndrome that slowly progresses and then typically resolves just as the pain begins. While the most common type of migraine aura involves visual disturbances , many people experience numbness, confusion, trouble speaking, vertigo and other strokelike neurological symptoms. Some patients may experience auras without headaches.

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What Symptoms Must You Have To Be Diagnosed With A Migraine

Migraine with aura . This is a headache, plus:

  • Visual symptoms or vision loss.
  • Sensory symptoms .

Migraine without aura . A common migraine is a headache and:

  • The attacks included pain on one side of your head.
  • Youve had at least five attacks, each lasting between four and 72 hours.

Plus, youve experienced at least one of the following:

  • Nausea and/or vomiting.
  • Lights bother you and/or you avoid light.
  • Sounds bother you and/or you avoid sounds.


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