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Diagnosis of Migraine & Headache Types

Visual problems ongoing 2 months after migraine

  • By JulianF

    Hi,

    I signed up to this forum as I am desperate for help with an ongoing issue.

    Just over 20 years ago when I was 19 I lost an eye due to an injury and I have suffered with migraine for the last 5 years, normally only 1 a year but always the same, loss of central vision which gets larger until almost all vision is gone. Normally just before this I start with flashing lights to my right. Sometimes this gives major headache but usually go to bed and it’s fine by the next day.

    Last year after a migraine my vision didn’t return to normal. Because of only having 1 eye this was very worrying but a checkup showed there was no problem with my eye at all. I had a nasal infection soon after and the antibiotics I took cleared the infection and my vision came back to normal at the same time.

    This year I’m suffering with the same. It started 8 weeks ago with a migraine which had just the visual symptoms which seemed to clear after a couple of hours but no headache. I’ve tried antibiotics again which seemed to help for a couple of days but symptoms have now returned. I have also seen several eye specialists who confirm no physical issue with my eye and am now waiting to see a neurologist which is at least 2 weeks away. One of the eye specialists I saw asked what medication I take for migraine, but I’ve never been offered any medication. I spoke to my GP by telephone today who was certain that if I don’t have headache and the visual effects have lasted 8 weeks then it cannot be migraine and no medication could help.

    I wanted to get people’s opinions on whether these symptoms could be migraine? It’s difficult to describe the visual problem, some flashing, but mainly it feels as if there is something extra in my vision and I have to concentrate hard to read or work which is becoming very difficult. I feel some motion sickness and have had some pins and needles in my left hand, I also feel unsafe to drive.

    I work for myself writing software and this is becoming a nightmare, I am living in the UK and feel completely let down by the health care I am receiving.I’m trying to go private to speed up the process but I’m still having to wait weeks to see a neurologist.

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  • By Tammy Rome

    Although we cannot diagnose, it is possible that you are experiencing either Retinal Migraine, Typical Aura w/o Headache, or Persistent Aura w/o Infarction. I have included the ICHD-3 diagnostic criteria for each one.

    Please see a headache specialist for an accurate diagnosis and correct treatment. Only a headache specialist can truly determine which (if any) of these (or others) apply to your situation. Most GPs don’t have the necessary training to accurately diagnose and treat all kinds of headache disorders. They are trained to treat the most common and easily treated Migraines, but with hundreds of headache disorders, only a specialist can sort it all out.

    If you need help finding a good specialist, please visit: https://migraine.com/blog/the-mrf-directory-of-headache-and-migraine-specialists/

    1.2.4 Retinal migraine
    Description: Repeated attacks of monocular visual disturbance, including scintillations, scotomata or blindness, associated with migraine headache.

    Diagnostic criteria:
    A. At least two attacks fulfilling criteria B and C
    B. Aura consisting of fully reversible monocular positive and/or negative visual phenomena (e.g. scintillations, scotomata or blindness) confirmed during an attack by either or both of the following:
    1. clinical visual field examination
    2. the patient’s drawing (made after clear instruction) of a monocular field defect
    C. At least two of the following three characteristics
    1. the aura spreads gradually over 5 minutes
    2. aura symptoms last 5-60 minutes
    3. the aura is accompanied, or followed within 60 minutes, by headache
    D. Not better accounted for by another ICHD-3 diagnosis, and other causes of amaurosis fugax have been excluded.

    1.2.1.2 Typical aura without headache
    Description: Migraine with typical aura in which aura is neither accompanied nor followed by headache of any sort.

    Diagnostic criteria:
    A. Fulfils criteria for 1.2.1 Migraine with typical aura
    B. No headache accompanies or follows the aura within 60 minutes.

    1.4.2 Persistent aura without infarction
    Description: Aura symptoms persisting for 1 week or more without evidence of infarction on neuroimaging.

    Diagnostic criteria:
    A. Aura fulfilling criterion B
    B. Occurring in a patient with 1.2 Migraine with aura and typical of previous auras except
    that one or more aura symptoms persists for 1 week
    C. Neuroimaging shows no evidence of infarction
    D. Not better accounted for by another ICHD-3 diagnosis.

    You can view and download the complete ICHD-3 at http://cep.sagepub.com/content/33/9/629.full.pdf+html

    Hope this helps. Please write back and let us know what happens.

    Tammy Rome, Patient Advocate

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  • By JulianF

    Thanks so much for the information, it does sound like persistent aura w/o infarction. I’ve been lucky enough to have some improvement this week which has at least made me calmer about what’s happening.

    I have a neurology appointment in a few weeks and if anything is discovered which I think could help this community I’ll post back.

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  • By elbe1981

    I hope you still have access to this account. I read your post about having vision loss in one eye, and then an assumed ocular migraine for months on the other, getting worse with use so you couldn’t drive or read…. this is my exact life.

    I had good vision prior. Had a laser treatment on my eye for CSR, but something went wrong and it burned my eye so I am blind in the middle. That was over three months ago and ever since then my good eye that didnt even have a laser treatment done and has never had issues is almost as bad as my blind one. It’s a constant swirling light with a small strobing. It gets worse when I focus on anything, basically taking over the vision in the center so I can’t read. Since the other eye is blind in the middle it has been so debilitating. My left eye is fine in imaging and mri came back fine. Eye doctors are stumped and I worry don’t believe me since it’s been over 3 months and they can’t find a reason. I went to a neurologist to see if it could be an ocular migraine for months and he said no.

    Did you ever get a diagnosis of migraine or anything else? Since you also had other eye damage I’m hoping I can compare and would love to know if this someday went away for you or if a different diagnosis was found or cure. I worry this is permanent and I’m loosing my business and can’t drive which is so life altering for myself my kids.

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  • By JulianF

    Hi, I’m in a different situation as I completely lost my eye when I was young, 19, I’m now 45.

    I was never able to get a diagnosis for why my vision wasn’t right. One thing to ask is do you notice that words on signs take more effort to read now? I found it very difficult to explain what I was seeing but when my vision is good I could see words on signs automatically without taking any effort for me to focus and read the sign.

    Another thing I noticed was inverted after images. If I looked at a screen with big black writing and then looked away, I would see a white version of the text.

    I got lucky that a doctor believed my own diagnosis that it was linked to migraines. I tried a few medications but then tried Amitriptyline 50mg. It has many uses including for depression and muscle problems. They fixed my vision problems very quickly. I take them 2 hours before going to bed and they knock me out when it is time to sleep.

    For me they slow down my overactive brain so when I go to bed I don’t lay there worrying about things. In the morning when I wake up I don’t immediately have all the things I worry about sitting in my head. It may be as simple as them allowing me to have a really good night’s sleep.

    They haven’t fixed my migraines completely, 2 weeks ago I had the aura but now I can just lie down for an hour and the aura goes away.

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  • By jimmyh5

    I have been having the same issue. I had my first migraine for years 3 weeks ago but my vision hasn’t been the same since. Hard to describe why. Usually I would be able to read and scan a newspaper. Feel like I can’t focus. My hands still feel numb and neck is tender. I can’t seem to shift it.
    I am going to drs tomorrow, not sure if they can do anything for me though?
    Very frustrating!

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