Scintillating scotoma, now what?

April 15, 2011 7:21 AM

I got my first scintillating scotoma, now what?

Yesterday after playing PS3 I sat down at the computer and was having difficulty seeing. This is exactly what I saw. I lied down for half an hour, it slowly got bigger and then went away. No headaches.

What causes it? Is working on a computer all day bad for this? Could it have been triggered by the videogame? I was playing Modern Warfare 2 on a 40 inch screen, sitting about 2 meters away from the screen. I had been playing roughly for 1 hour. I have played for longer than that on occasion with no adverse effects. Should I cut down on the videogame? Should I go easy on the eyes, like say avoiding the movies if the film has lots of cuts and a jerky cam?

Also, I have high blood pressure. Could this be related? I'm a 40yo Caucasian male.

posted by Tom-B to Health & Fitness (10 answers total)

It could be triggered by anything that triggers migraines. These vary from person to person, but migraines often occur only when you combine several of your triggers at once, which makes it harder to figure out what they are, since any one by itself is often okay. To complicate things further, the effects of some migraine triggers are delayed by one or two days. If you ever have a reason to track down food triggers, you will have to make a note of what you ate for two days preceding the migraine, not just the day of the migraine.

Common migraine triggers include bright lights, skipping meals, inadequate sleep, and foods such as bananas, cheese, red wine, or anything with MSG or yeast extract. Skipping your usual caffeine intake will often trigger a migraine.

If you have untreated high blood pressure, getting that under control should be your first priority, whether or not it had anything to do with your scotoma. High blood pressure usually doesn't cause symptoms while it's destroying your body.
posted by Ery at 7:34 AM on April 15, 2011

There's almost always a combination of triggers involved in any of the migraines I get (always preceded by the scotoma), but the main factor I've only become aware of in the last year is that my migraines always happened while I was relaxing after having been stressed, so I've been working on not getting stressed out, and I haven't had a migraine so far this year, even on days when several of my triggers were in effect. So, there's the possibility that getting stressed out by the game might've set it off for you once you calmed down.
posted by kimota at 7:58 AM on April 15, 2011

The underlying phenomenon is cortical spreading depression. If it happens infrequently, does not last for more than a few hours, and is not associated with any other symptoms, then you're probably fine—no need to worry. To test if you're having a stroke, check your smile in the mirror (is it even?). Balance on one foot. Carry on a conversation. No problems? No problem.

If it's in your right field of vision (in both eyes), it's happening in your left occipital lobe. If it's in your left field of vision (in both eyes), it's happening in your right occipital lobe. I don't think the causes are understood. Increasing O2 supply is supposed to help.
posted by dephlogisticated at 8:10 AM on April 15, 2011

Could be your blood pressure. My understanding is that it has to be pretty high to start causing scotomata.
Could be migraine related, even if you've never had them before. That's what it usually is for me. Was it followed by head pain, stomach pain, vomiting, or an odd sensation (I usually describe it as fizzy, which probably makes zero sense to anyone who hasn't experienced it) in your head? Any of those could be migraine related.
posted by willpie at 10:19 AM on April 15, 2011

I had one once when I was moderately hung over. I don't get migraines, and I've never had a similar episode since.
posted by rocket88 at 11:15 AM on April 15, 2011

Response by poster: Hi Ery, yeah, I take meds for blood pressure, but since it's asymptomatic, I often forget it. Willpie, no pain of any kind afterwards, no vomiting. No fizzy sensation either.
posted by Tom-B at 11:15 AM on April 15, 2011

I sometimes experience that from staring at bright lights. But you should get your blood pressure checked just to be on the safe side. Make an appointment to get your BP checked by your doctor, and in the mean time, you can check it at home, or in a pinch, use one of those weird BP robots they have at the drug store.
posted by ladypants at 4:31 PM on April 15, 2011

That has happened to me a few times, with no apparent causes, no apparent consequences. I'd write down the date and circumstances for future refernece, in case it happens again. And I suggest you take your meds more regularly.
posted by exphysicist345 at 4:49 PM on April 15, 2011

I was in my late 40's when I had my first similar experience. It has now happened to me three or four times over perhaps six years, with no identified or even suspected triggers. Never had a headache associated with it, nor (as far as I know) any migraines at all.
posted by Snerd at 5:41 PM on April 15, 2011

Hi. I'm a migraineur and a neuroscience RN. There's really no good answers to your questions right now because it's a one time incident. I would look at things that you did differently that day- did you eat a new food? Did you wake up early or go to sleep late or some other change in routine? A change in medication? Also, do you have any significant family history? Parents or siblings with neurological issues- migraines? chronic headaches? strokes? seizures? etc. I'd definitely see a doc. It's also a good time to (re)familiarize yourself with stroke symptoms.
Also you should take your prescribed BP meds. High blood pressure is often asymptomatic, that's why it's called a silent killer.
posted by brevator at 5:46 PM on April 19, 2011