Visual Symptoms in Migraine: Causes, Treatments, and Duration

Q: Visual Symptoms in Migraine: Causes, Treatments, and Duration

Hello： <br>1. <br>What medications are typically prescribed to alleviate migraine with visual symptoms? <br>A： If the visual symptoms occur within half an hour before the headache, it is referred to as migraine with aura. <br>Medications such as ergotamine (e.g., Cafergot) or tri

Migraine with visual symptoms

Hello Doctor: Recently, I have been experiencing zigzag-shaped flashes in my left eye every few days (without headaches), and whenever I lie down, I notice a slight flashing sensation, similar to a light bulb repeatedly turning on and off, or like television static, with many white dots flashing.
Therefore, I went to a large hospital for an MRI of my head and an EEG, and the doctor said everything is normal, suggesting it is likely just typical migraine.
However, when I asked the doctor why visual disturbances occur more when lying down, he only replied that it usually doesn't happen that way.
I've been taking medication for almost two weeks, but it doesn't seem to improve much.
Therefore, I would like to ask: 1.
What medications are typically prescribed to improve migraines with visual symptoms? 2.
Why are visual disturbances more likely to occur when lying down compared to standing? 3.
How long do people usually need to take medication for migraines with visual symptoms before seeing significant improvement? 4.
Is there a specific duration for the treatment, such as taking medication for three months? 5.
Are zigzag-shaped flashes associated with migraines a lifelong symptom? Is there a way to completely eliminate them? I apologize for asking so many questions!! Thank you very much, Doctor!!!!!!!!

Niming, 20~29 year old female. Ask Date: 2020/06/08

Dr. Jiang Junyi reply Neurology

Hello:
1.
What medications are typically prescribed to alleviate migraine with visual symptoms?
A: If the visual symptoms occur within half an hour before the headache, it is referred to as migraine with aura.
Medications such as ergotamine (e.g., Cafergot) or triptans (e.g., Imitrex, Maxalt, Relpax) can be used to reduce headache symptoms.
2.
Why is it easier to experience visual disturbances when lying down compared to standing?
A: Headaches related to posture may be associated with changes in intracranial pressure.
3.
How long do medications typically need to be taken for significant improvement in migraines with visual symptoms?
4.
How long is the treatment course? For example, is it necessary to take medication for three months or so?
5.
Are zigzag flashing lights in migraines a lifelong symptom? Is there a way to completely eliminate them?
A: If acute medication treatment is ineffective, or if there is an increasing frequency/dosage of pain medication usage, it indicates the need for preventive treatment.
Such medications include beta-blockers, calcium channel blockers (e.g., antihypertensive medications), neuromodulators (e.g., antiepileptic drugs), and antidepressants, as their pharmacological mechanisms have been found to improve the function of brain neurons and reduce pain generation, thus also being used for headache prevention.
Regular daily use for two to three months can reduce the frequency and severity of headaches.
I recommend consulting a neurologist to discuss evaluation and treatment, as members of headache societies tend to have more experience with headaches.
Wishing you good health, peace, and joy.

Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2020/06/08

More Info

Understanding visual symptoms associated with migraines can be complex, as they often involve a range of neurological and ocular factors. Based on your description of experiencing zigzag flashes of light, particularly when lying down, it seems you may be experiencing a type of migraine known as "migraine with aura." This condition can manifest with various visual disturbances, including scintillating scotomas (the zigzag patterns you describe) and other visual anomalies.

1. Medications for Migraine with Visual Symptoms: The treatment for migraines often includes both acute and preventive medications. For acute treatment, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can be effective. Triptans, such as sumatriptan or rizatriptan, are specifically designed for migraine relief and can help alleviate symptoms when taken at the onset of a migraine attack. Preventive medications may include beta-blockers (like propranolol), anticonvulsants (such as topiramate), or certain antidepressants (like amitriptyline). Your doctor may prescribe a combination of these medications based on your specific symptoms and medical history.

2. Why Visual Symptoms Occur More When Lying Down: The reason you may experience visual disturbances more prominently when lying down could be related to changes in blood flow or pressure in the brain and eyes. When you lie down, the dynamics of blood circulation can alter, potentially affecting the way your brain processes visual information. Additionally, lying down may increase intracranial pressure or change the way your optic nerves are stimulated, leading to more pronounced visual symptoms.

3. Duration of Medication for Improvement: The duration for which you may need to take medication can vary significantly from person to person. Some individuals may notice improvement within a few weeks, while others may require several months of consistent medication to achieve significant relief. It is essential to maintain open communication with your healthcare provider about your symptoms and any side effects you may experience, as they can adjust your treatment plan accordingly.

4. Length of Treatment: The length of treatment can also vary. Some patients may need to be on preventive medication for several months or even longer, depending on the frequency and severity of their migraines. Regular follow-ups with your healthcare provider are crucial to assess the effectiveness of the treatment and make any necessary adjustments.

5. Long-term Outlook for Zigzag Flashes: Zigzag flashes associated with migraines can be a recurring symptom for some individuals. While some people may experience a decrease in the frequency and intensity of these symptoms over time, others may continue to have them throughout their lives. Currently, there is no definitive cure for migraines, but many people find that with appropriate treatment and lifestyle modifications, they can manage their symptoms effectively. Identifying and avoiding triggers, such as certain foods, stress, or lack of sleep, can also help reduce the frequency of migraine attacks.

In conclusion, while your symptoms may be concerning, they are not uncommon among individuals with migraines. It is essential to work closely with your healthcare provider to find the most effective treatment plan tailored to your needs. Keeping a migraine diary to track your symptoms, triggers, and medication response can also be beneficial in managing your condition. If your symptoms persist or worsen, do not hesitate to seek further evaluation from a neurologist or headache specialist.

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