‘It starts as a line of light, then works its way through my sight’: The Disorienting Mystery of Migraine Auras | Health & Wellbeing

lee Ashdown was in the pub having a quiet drink after work when he suddenly turned around and couldn’t see half of his friend’s face. “I assumed I had had too much to drink because I just felt completely disoriented.” He quickly made up his excuses and left and went straight to bed when he got home.

But the distorted view returned and soon formed a pattern. “It starts as a blurry line of light in the lower corner of both eyes and works its way through my field of vision for an hour,” says the 37-year-old auditor from Heathfield, East Sussex. “Then it slowly disappears into the upper corners. Then the headache sets in.”

A few months later, he went to his family doctor, who told him these were migraine auras. Migraines affect about 10% of the population in the UK, according to the National Migraine Centre. One in three of those people will experience auras. Confusing for anyone who equates migraine with pain, sometimes auras will appear without a headache; these are known as “silent migraines”.

Auras can be visual — normally they come in the form of flashing lights, zigzag patterns, or blind spots — but they can also include other symptoms such as ringing in the ears, pins and needles, imaginary odors or aphasia, where a person temporarily loses the ability to speak or hear others. to hear.

Many patients worry about having a transient ischemic attack (TIA), also known as a mini-stroke. However, the symptoms of a migraine aura are usually “positive” (such as flashing lights and tingling skin) and develop quite slowly, while those of a TIA are likely to be “negative” (loss of feeling in your hands or your vision in one eye, for example) and coming on suddenly.

Zoe, 27, has had migraine auras since she was nine. “I get zigzag lines. They are the same colors every time – very intense blue, pink, yellow and black.” Each aura lasts for two to four hours, with the intense headaches starting as they subside.

“I also get pins and needles, trouble speaking, loss of feeling in my hands and my legs… Sometimes it’s so bad I can’t even walk.” She also suffers from tinnitus during these attacks. “I get buzzing sounds like bees or wasps flying around my head.”

Zoe, who is a court clerk and lives in Leeds, has had problems at work due to the amount of time it takes to get out as she has up to 20 migraine auras a month. (An MRI ruled out other causes.) They also meant she had to forgo last minute friends’ birthday parties and miss important family events. “It just takes its toll, not being able to leave the house or do anything,” she says. “I struggled with depression at one point.”

Migraine auras are caused by something known as cortical diffusion depression: a wave of electrical activity that travels through the cortex of the brain. dr. Mark Weatherall, a neurologist at Stoke Mandeville Hospital in Buckinghamshire and president of the British Association for the Study of Headache, likens it to “a small tsunami, a wave of overactivity followed by a trough of underactivity”.

These happen spontaneously, mainly in the visual part of the brain, and are not harmful, he says. “As that wave spreads across the surface of the brain, it hits every bit of the visual part of the brain. The overactivity causes the flashing lights or the zigzags, and then you get a period of underactivity, and that’s where you get the blind spots. Eventually that will become clear.”

For most people who suffer from migraine auras, Dr. Weatherall says, “they just need to rest and let them pass.” There are no treatments available for auras, only for the headaches. Mild pain can be treated with over-the-counter pain relievers such as ibuprofen, acetaminophen, and aspirin. Research has shown that supplements such as magnesium and vitamin B2 can help prevent migraines, while coenzyme Q10 shortens the duration of an attack and ginger helps with pain and nausea.

For more severe attacks, triptans, anti-inflammatories, and anti-nausea medications may be prescribed by your primary care physician to manage nausea and pain. Beta blockers, antidepressants, and anticonvulsants are also used to reduce the frequency of migraines.

Identifying personal triggers can be helpful. Dr Dawn Sim, a consultant eye surgeon at Moorfields Eye Hospital and co-founder of the eye health brand MTHK, often has patients come to her with migraine auras, fearing that there is something wrong with their vision. After doing a thorough eye exam to rule out other conditions, she sits down with them to find out what their triggers are.

“Lack of sleep, caffeine, chocolate, tea, cheese and red wine… I tell people these things and they say, ‘Oh, so all the good things in life?’ You need to identify your trigger. If it is excessive consumption or a small piece of cheese that starts it, in that case, you should try to eliminate it from your diet. If it is [auras] without a headache, it usually doesn’t affect people’s lives.” For people who also suffer from debilitating migraines, she refers to the general practitioner or a neurologist.

Kim Oliver for a visually shocking mural.
Kim Oliver, who quit her job because of migraines. Photo: Christopher Thomond/The Guardian

“My food intolerances are pork and cheese,” said Kim Oliver, 50, of Liverpool, who has been medically retired from her job as an administrative officer because of her migraines. She started having migraine auras in 2006. “Bacon, sausage, pate — all my favorites — within 20 minutes of eating them, I’m gone.”

A 2007 US study of more than 1,200 people with acute migraines found that nearly 80% of participants considered stress to be an important factor. Other triggers were hormones in women, hunger, sleep disturbances, odors, neck pain, alcohol, smoking, heat, light, food, exercise and sexual activity.

Just over 53% also noted that weather was a factor, which is true for Oliver. “When it’s cloudy and rainy, these are my worst times,” she says. Also for Zoe it seems to be the most consistent trigger. Her seizures can be triggered when it’s “musty or damp, or when it’s cold and then suddenly gets really hot.” Ashdown agrees: “The only thing I can think of that seems to correlate with getting this one is when it’s pretty stormy.”

Migraines, and particularly migraines with auras, are associated with a slightly higher risk of death from cardiovascular disease. But dr. Weatherall emphasizes that there is no need to panic. “The vast majority of people who get migraines have no sequelae.” Likewise, he says, “Nobody has ever done a study showing that if you reduce the frequency of people getting migraines, you reduce the risk of heart disease or stroke.”

As for Ashdown, he’s still praying for healing, after nearly 20 years of misery and countless tests to find out if there are any underlying issues. He’s wasted too many days in a dark room waiting for the migraine auras to pass.

“I could make my peace with them if I knew when they were going to happen. It’s not knowing. I have to organize a bachelorette party for my boyfriend. If I’m gone and I get one, what should I do? I hope one day something will come out that can prevent them.”

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