Understanding Migraines and Migraine Auras Everyday Health
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Understanding Migraines and Migraine Auras
By Dr. Stuart R StarkReviewed: April 14, 2008Fact-CheckedQ1. It seems as though when my blood sugar drops, I get an aura to a migraine. I lose my vision in one eye. I get these colorful, zigzag flashing lights. I eat and rest for about 20 minutes. It goes away, and I never get the headache pain. I am not diabetic. What’s going on? Your symptoms sound typical of migraines without a headache, or migraine auras. Migraine attacks may be triggered by any acute metabolic abnormality or problem, including hypoglycemia (low blood sugar). This seems to be the trigger in your case. The most common symptom during a migraine attack is a throbbing or pounding headache. However, a minority of migraine sufferers, like you, get non-headache symptoms only. Acute visual disturbance is the most common. Seeing colored, zigzag lines in one’s field of vision is the most common description of the visual aura of migraine. Q2. I have had migraines once or twice per month for the past eight years. I have been taking propranolol as a preventative for the past six months and recently increased dosage from 20 to 40 mg twice a day. I do not have painful migraines now, but I do have fatigue, numbness in extremities, irritability and now before having a migraine I have an aura! I never had that before I began taking the medication. Is this unusual and why would this happen? It's as though the migraine is fighting to make itself known somehow. The most common form of migraine is migraine without aura. Beta-blockers, such as Inderal (propranolol), can definitely cause the attacks to change in quality or quantity. I have seen a number of patients with longstanding migraine without aura who began having attacks of migraine with aura or typical aura without headache when they started taking a beta-blocker or when they increased the dose. Beta-blockers may cause other side effects, especially fatigue and numbness in the extremities. Although you are not having painful migraines on propranolol at your current dose, I suggest that you ask your doctor to reduce the dose to 30 mg twice per day to see if you can keep the therapeutic benefit but decrease the side effects (auras, fatigue, etc.). Alternatively, your doctor could prescribe a different class of medication to prevent migraines, such as Topamax (topiramate) or a calcium-channel blocker. Q3. I used to suffer from migraines, but a former doctor put me on Cardizem for my blood pressure , and since then I have had no headaches. I do have the auras, but no pain. Recently, I have had "fans" circulating in front of my eyes (whether closed or open) which interferes greatly with my sight and balance. Are these "fans" a new type of aura, or should I go to a doctor who specializes in whatever might be causing these? I am glad that you are headache-free on Cardizem (diltiazem), a calcium-channel blocker. Sometimes, a preventive medication reduces the headache frequency but the auras increase in frequency or change in quality. Therefore, the “fans” in your visual field may be a different aura. Another possibility is that the “fans” are a side effect of Cardizem, in which case they would likely last for longer than several minutes at a time, or may even be continuous. Auras usually last for one to two minutes and rarely occur more than several times per day. Other diagnostic possibilities exist but are unrelated to the migraine disorder or to Cardizem. I recommend that you see a neurologist initially. Learn more in the Everyday Health Headache and Migraine Center.NEWSLETTERS