are all migranes knock-you-out bad?

January 15, 2007 9:22 PM

Is there such thing as a "light" migraine?

a little under a year ago, i started noticing some strange flashing in my left visual field. the best way to describe it would be a brief flash (milliseconds), which would then leave a negative afterimage lasting 1-2 sec. the shape of the light is very fractal-like, and always on the left.

i saw an optometrist, who declared my retina normal, and saw no pressure on the eyeball. i then saw my GP, who referred me to a neurologist. i got sick before the neuro appointment and never went. sometime later, at another (regularly scheduled) optometrist's appointment, i mentioned the flashes were still there. the optometrist asked if i ever get migranes, and i said no. he mentioned that he had a patient who had similar flashing when dehydrated, though.

then i started noticing some aching in my left eye, and week+ long 'low intensity' headaches, confined to the left hemisphere of my head. the flashes seemed to stop during the headaches. operating on the assumption that i was having migraines, i stopped coffee, diet coke and nutrasweet, and made sure that i was incredibly well hydrated at all times - dehydration does cause pretty severe headaches for me. for a while the flashing and headaches stopped, but now they have returned. there may be correlation with eating chocolate, but i'm not sure yet.

unfortunately, i've also developed an allergy to NSAIDs (hives) and so i'm reluctant to take the normal OTC remedies for headache.

i know i need to see a neurologist. but before i do, i want to understand if it is possible to have a 'low intensity' migrane headache. i've always associated migranes with a knock-you-out, incredibly painful, nauseating headache, and this is not what i am experiencing. it does affect my cognitive function in that it bothers me and makes it difficult to concentrate on my work, and so i'd like it to stop.

the main reason i'm thinking this is 'migraine' is that the flashing seems to precede the headache and as such could be a migraine aura.

anyone else with 'low intensity' headaches which have been diagnosed as migraine?

posted by joeblough to health (21 comments total)

I've had migraines since I was 10 (I'm 33 now). I'm sure this depends on the person, but migraines can certainly vary in intensity. I sometimes have the debilitating, have-to-lie-down-in-a-dark-room-right-NOW variety, but, fortunately more often, I get ones that aren't nearly as bad but are most definitely migraines.

I've never had the aura, for some reason, but what you describe sounds similar to stories I've heard from others.
posted by cerebus19 at 9:54 PM on January 15, 2007

There are a wide variety of migraines -- many migraneurs don't have headaches at all. More importantly, perhaps, there are a lot of different things that can cause the symptoms you're having. Some of those things are the kind of stuff that a neurologist should check out right away -- tumors and whatnot.

In other words, get your rear to that doctor's office.

Oh, and I'm a migraneur who has a broad variety of headache intensities.
posted by YoungAmerican at 10:12 PM on January 15, 2007

An excellent book on the subject - most migraine sufferers own and relate to the case studies within this book. There are myriad types of migraine symptoms - I don't experience the visual effects that normally mark the onset of migraine, but get numb hands - this is all to do with the constriction of the blood vessels prior to the consequent dilation that causes the pain (in my case, at least). Thankfully after taking blood vessel regulators for several months, my lifelong fight with this most depressingly painful syndrome is now over.

Definitely see a neurologist, though.
posted by strawberryviagra at 10:25 PM on January 15, 2007

Yes, it could be migraines. However, when I get vision symptoms before a headache, they're always similar (various sections of my vision drop out) but never exactly the same. You're getting exactly the same thing in exactly the same place, and constant headaches. You should absolutely see a neurologist.

If he can't find anything, try eliminating MSG from your diet. This is harder than it sounds, because it's in nearly all packaged foods. (it's usually called Natural Flavors, but it's hidden many other ways too.) You mentioned that removing aspartame helped. MSG/aspartame cross-sensitivity is quite common, to my knowledge. (I'm badly messed up by both substances, for example.) Your mention of chocolate also makes me think MSG is possible, because most candies are LOADED with it.

But, first, hie thee to a neurologist, stat. If you get a clean bill of health from him, then start on diet adjustments.
posted by Malor at 10:50 PM on January 15, 2007

Yes, I get "light" migraines: visual disturbances plus occasional numb hands culminating in a moderate headache.

Aside from 20 minutes or so of the "aura" period, when I can't see well enough to read or drive, they are unpleasant but not debilitating.

As others have noted, I think the intensity of the headache and other symptoms varies from person to person.
posted by ottereroticist at 10:50 PM on January 15, 2007

yes, i plan on going to the neurologist. my wife is a doctor though, and she's mostly unconcerned with my symptoms. also i recently had full bloodwork done and there were no signs of cancer. i discussed taking the various industrial strength anti-migraine medications with her and she kind of scared me - she said that the side effect of at least some of those drugs is stroke. given the fact that i can still function, that kind of put me off trying those drugs to see if the headache goes away.

believe me, at first i was convinced i had a brain tumor!

huh, i didnt know oliver sacks's first book was about migraines. i'll have to check that out.

thanks for the replies so far.
posted by joeblough at 10:52 PM on January 15, 2007

I experienced a scintillating scotoma (also known as a migrane aura, this image is the closest thing I found on-line to what it looked like.) a year or so back. I discovered that it usually precedes a migrane, but doesn't have to -- see the classifications here, note "Typical aura with non-migraine headache". I had a very mild headache for about a day afterwards, but since my hay-fever happened to disappear for the duration, it was increadibly easy to cope with.
posted by krisjohn at 10:56 PM on January 15, 2007

I get clusters of symptoms that often go with migraines --- photophobia, mild clumsiness, difficulty thinking --- but they're usually associated with very mild headaches, only rarely with the stereotypical asymmetrical nail-in-the-head kind of headache. I assume it's a migraine with a slightly atypical set of symptoms, but I haven't been officially diagnosed.
posted by hattifattener at 11:32 PM on January 15, 2007

Next time to get the aura - have a good strong espresso or hit of caffeine (which is a vascular constrictor) - that may negate the onset of your headache (used to work for me).
posted by strawberryviagra at 11:38 PM on January 15, 2007

Next time you get the aura ...
posted by strawberryviagra at 11:39 PM on January 15, 2007

I had brutal migranes in my teens and early 20s - agonizing, with cognitive and perceptual defects - and then none for ten years or so until two summers ago when while having lunch with the newspaper I had just the faintest headache and then realized I couldn't read. I felt OK, but could not get through a sentence with any comprehension, no matter how deliberately I tried to put the words together. That lasted for about four hours, and it was very like a "light" migrane, with the neurological symptoms but without the pain.
posted by nicwolff at 11:59 PM on January 15, 2007

I've had a couple ocular migraines that sound similar to what you're describing. Over a period of about 20-30 minutes, a flashing/shimmering blob moved across my vision, developed into a blind spot, then left. Afterwards, I had a bit of a headache and was slightly nauseous for the rest of the day.

And I second the suggestion to watch out for MSG. That gives my dad horrible migraines. (He can usually head them off at the pass by drinking a can or two of Coke as soon as he starts feeling them. Something about caffeine helps.)
posted by belladonna at 1:27 AM on January 16, 2007

I too have had an ocular migraine, on only one occasion, though it wasn't accompanied by much of a headache. Very similar to that belladonna describes.

My father was struck down for years by migraines (one after the other, lasting a week to 10 days in total, every few weeks), and took Nurofen (ibuprofen) like candy. After making many dietary adjustments (eliminating dairy in particular), around ten years ago he had all his amalgam fillings extracted and migraines became a thing of the past for him.

I'm fascinated by the mentions of MSG; does anyone have any more information about links between MSG and migraine?
posted by snap, crackle and pop at 2:40 AM on January 16, 2007

I have a visual migraine about twice a year. I get a similar image most of the time, and the light show is followed by a low grade headache in about a half hour that lasts 4 to 6 hours. No big deal, and I didn't get them until after 50.
posted by unrepentanthippie at 5:00 AM on January 16, 2007

Twice in my life I've had periods for a couple of months were I had exactly the sort of ocular migraines belladonna and S,C,P describe several times a week. Scare the living daylights out of me when it first happened. After a few months they go away for years. Very odd.
posted by prentiz at 6:07 AM on January 16, 2007

I get migraines -- frequently the low-intensity ones like you describe (though I don't get auras, just sensitivity to light) and occasionally much stronger ones.

Like you, I also try to avoid medication unless it's truly necessary, and I've found a few things that help with the migraines:

- Staying hydrated. I almost never get them when I've been drinking lots of water.

- Getting lots of potassium. If I feel a migraine coming on, I can frequently get rid of it entirely by eating a banana.

- Avoiding caffeine (but by the same token, if I've been having a lot of caffeine lately, going cold turkey will also give me a migraine).

I've heard about the MSG-migraine connection too, but in my experience I haven't found any correllation (we used to eat out a lot at a restaurant we later discovered used lots of MSG, and when it closed I didn't really notice any drop-off in the frequency of my headaches). That's not to say that it might not be a trigger in some people though -- so it couldn't hurt to try cutting down.

Hope this helps!
posted by AV at 7:00 AM on January 16, 2007

Aren't the symptoms you're describing possibly explained by the onset of multiple sclerosis? The flashing doesn't sound exactly the same, but see the description of Optical neuritis which is associated with MS. It's probably not, but it's at least something to look into.
posted by Durin's Bane at 7:25 AM on January 16, 2007

I second avoiding all medications, but if your allergic to NSAIDs, but still desperately need a pain killer, you might -- with extreme caution -- investigate an opiod, like codeine, or a barbiturate, such as Fiorinal.

Fiorinal includes a bit of aspirin and caffiene, in addition to the barbiturate (butalbital). It's highly addictive in large amounts, of course. Paging Judy Garland. Is Judy Garland in the house?

But two or three a day should be non-addictive, and (in my case) delete the migraine pain with far more enthusiasm than aspirin or OTC painkillers.

There's a boat-load of prescription painkillers that migraineurs take, so check 'em out, if your willing to take on the risk for the pain-free reward.
posted by Gordion Knott at 7:56 AM on January 16, 2007

Re: Migraines and MSG or Aspartame

I've had migraines since I was five. yay.

MSG *is* a neurotoxin and Aspartame breaks down into three ( I forget which ) neurotoxins at room temperature, which basically means that most aspartame containing products will expose you to the neurotoxins in question.

Now, just because something is or contains neurotoxins doesn't *necessarily* mean you need to avoid it. EG: Tomatoes. Tomatoes have poison in them, but they also have the antidote for the poison in them (oddly, except for some of the newly engineered tomatoes which cannot be used for canning). And most neurotoxins that we commonly encounter require build up to be a problem.

Chronic migraines are a result of some sort of neurological disorder. It's all in the nervous system and the brain. Now, if your nervous system is already tweaked, then the added stress of neurotoxins is not likely to go over well. Hence, MSG & Aspartame=migraines.
posted by jaded at 8:55 AM on January 16, 2007

thanks again everyone for the replies.

i think i'll try the shot of caffeine trick. i had been drinking 4-6 diet cokes a day and one cup of strong coffee in the morning, so i wanted to eliminate that drug for a while to see if it had any effect. it seems not to be the trigger but in any case drinking so much diet coke can't be good for someone.

Durin's Bane - yes, i was very worried about optical neuritis when this first manifested. when it was followed by the headache like symptoms, i decided it was more likely to be migrane. to be honest, people's descriptions of the migrane aura, both here and elsewhere, would indicate that the aura is usually much more intense than what i'm getting. i'm never blinded nor does the aura fill my field of vision. my doctor was not concerned about MS but that's really more for the neurologist anyway.

the MSG thing is interesting. when i do eat chocolate, its usually swiss chocolate or something high quality, so i doubt it has MSG. i do eat lunch out every day, so i might be getting some amount of MSG in that food.

anyway, its good to hear that it is at least possible that this is migraine. next stop is the neurologist.
posted by joeblough at 9:01 AM on January 16, 2007

jaded - i wouldnt describe the byproducts of aspartame as neurotoxins. there may be some neurological effects, yes. but i've been aspartame-free for about 3 months and the headaches are still with me.

wikipedia
posted by joeblough at 9:10 AM on January 16, 2007