One of These Migraines Is Not Like the Other: Diagnosing Migraine Without Aura
When I was a kid my mom liked to tell me I was unique. She’d smile and whisper in my ear that no one was exactly like me. Her go-to example was, “You know, no one else in the whole world has your fingerprint.” I was impressed. I marveled at how neat the spiral on my thumb looked knowing I was the only person who had it. What I didn’t know was that later in life migraines would have me feeling a scary level of uniqueness I’d never known.
Definition of pain vs. my experience
When I first researched “migraine pain” I discovered The Mayo Clinic defined this as “severe throbbing pain or a pulsing sensation, usually on one side of the head.”1 This confused me. My head didn’t throb. It didn’t even pulse.
When talking to other migraineurs, they’d give me similar descriptions and then add, “My pain feels like an ice pick stabbing me behind my eye.” I didn’t even know what an ice pick looked like. I felt a little too unique in my pain experience. My head pain started in my jaw and ran up to my temple. I felt like a roasting-hot anvil had parked itself on the side of my head.
Missing migraine symptoms
Then there was my biggest problem — no aura. I learned migraineurs sometimes saw shining lights (like Richard Dreyfus in Close Encounters) before their migraine took hold. An aura seemed the most classic of migraine symptoms but it wasn’t mine.
Sure, these headaches made me vomit every now and then and kept me in bed for days with the curtains shut hoping my household would walk on pillows. I may have had some classic migraine symptoms, but they didn’t check off all the migraine boxes. Finally, too many pain-filled days checked off too many boxes on my calendar, so I started seeking medical help.
One of the first questions my general practitioner asked was, “Do you experience an aura at the onset of pain?” I told her no and she told me I didn’t suffer from migraine. Okay, what did I suffer from then? I felt totally alone.
Have you been diagnosed with migraine without aura?
"Do you experience an aura?"
While my head pain increased the answers to what was causing it decreased. With each new doctor, I visited one of the first questions asked was, “Do you experience an aura?” While studies show that only 20% of people experience an aura with their migraines, it seemed doctors I saw needed to check off that aura box to successfully diagnose me with migraines.
Finally, a diagnosis
As time passed, I understood my pain wasn't just a "bad headache." I continued to advocate for myself. I found a neurologist that knew migraines were as individual as the individual experiencing them. I was finally successfully diagnosed with hormonal migraines.
My mom was right. I am unique. Even though my migraines didn't manifest in a textbook way, that didn't mean they weren't in fact migraines. It took me some time, but I know now that migraine pain can be just as unique to a person as their very own fingerprint.
How much has your migraine disease changed or evolved over time?