Serene Branson & Complex Migraine: Unraveling the Mystery

Serene Branson had a complex or “complicated” migraine as witnessed by many of us. By now most of us have been informed that a “complex migraine” is a migraine with aura/neurological symptoms. In Serene’s case, the aura was considered complicated or “dense” and was characterized by incomprehensible speech. I watched one of her TV interviews last week. She stated she had a history of headaches but not migraine and never an episode like this.

The question I now pose is: WHY did it happen just at the moment she was reporting on The Grammy Awards? Undoubtedly, she had inherited a genetic predisposition to migraines as her mother had a history of migraines. My educated guess is that what she called her previous headaches was migraine but not migraine with aura. So, what has now been witnessed during her TV interview was most likely her FIRST AURA.

Stress is a huge trigger for migraine attacks on both men and women. Going on live TV and reporting on the Grammy Awards would certainly be a stressful event for even a seasoned reporter. It is possible she had not been getting a lot of sleep or not eating balanced meals leading up to the live report. In addition, there could have been a hormonal trigger that came together with the stress to create “the perfect storm” of triggers to cause the aura. Unlike migraine without aura that often responds well to estrogen if given in continuous manner, aura can be triggered by estrogen. The following hormonal situations can contribute to an aura:

  1. A woman is pregnant; in this case, the climbing and high estrogen levels can cause new-onset aura.
  2. A woman is put on birth control pills and develops new-onset aura.

I don’t know the specific hormonal milieu of Serene Branson when the aura occurred but I would certainly be asking about it if I were her physician. I would also recommend a full work-up including an MRI/MRA of the brain in view of this being a new-onset aura. My understanding is that had a lot of testing at UCLA on Monday and Tuesday last week after the event occurred. Her work-up was negative and then her doctor was able to reassure her that her symptoms were from a “complicated” or “complex” migraine which is more correctly called Migraine with Aura.

On a morning show I watched, Serene said she was given a triptan to take if this happens again. I would certainly recommend she evaluate the set of triggers that led up to this event, e.g. stress, lack of sleep, hormonal status, etc. In addition, I would offer her a daily preventive at least for several months to help prevent a similar episode. The triptan, if taken in the future, can help prevent a migraine headache from occurring after the aura but won’t prevent the aura symptoms themselves. I think a careful review of any possible migraine triggers, including hormonal status at the time of the aura, is critical in order to work to prevent similar future attacks which could negatively impact her career.

In my opinion, a combination of triggers came together that evening to create “the perfect storm” for Serene Branson’s now infamous aura witnessed by the world. I am glad she is going public with what happened; her experience may help others to understand and recognize symptoms they may be experiencing. Symptoms like hers should always be evaluated by a trained medical professional.

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