The migraine experience

I rarely experience a migraine headache but when I do, I usually see what is commonly referred to as a scintillating scotoma (visual aura), about a half-hour before the headache pain begins. This "warning sign" often allows me to take medication to ease or even prevent the migraine pain from occurring (caffeine often helps greatly).

As is typical for migraine sufferers, my experience began with central vision loss. I was working at my computer and suddenly became aware that I was having difficulty seeing what I was typing. Years of experience have taught me to recognize the signs and so I was not alarmed. Over a period of about 15 minutes this area expanded and the aural pattern became more apparent. Finally the pattern expanded out and beyond my visual field entirely.

On this occasion I "saw" the clearest visual aura I can remember having, although it was never quite in my central area of vision, but always "off to the corner" of my visual field. So although I couldn't look at it directly, I could still "sense" things quite clearly.

In the above illustration (drawn by me during the occurrence and placed over an arbitrary photograph), the center of the image corresponds to my central foveal vision. This would be toward the end of my aura experience, but before the aura has expanded and left my field of view entirely. The actual scintillating scotoma "flutters" and does not appear to be static, as it does in the illustration.

My friend Steven Lehar helped me to better understand what I was experiencing, pointing out that most people report seeing the "battlement" or "fortification" patterns as mostly colorless, transparent texture, like this: //\\//\\//\\//\\ . "They usually 'kindle' (ignite) at one spot," said Steve, "then slowly expand outward until at a certain distance they fade away."

Yet this was the first time I recall seeing colors in aura pattern, and quite clearly. They were as depicted: red, yellow, and blue, with black and white "battlement" lines between. It occurred to me that there might be some significance to these being primary colors, plus black and white (any insight from Machines Like Us readers is welcome).

I typically see an aura almost exactly one half hour before the headache pain begins, and if I take no medication, full-blown migraine pain starts another half hour after that--complete with light and sound sensitivity. Knowing the warning signs as I now do, however, often gives me time to take medication to help. On this occasion I took two Excedrin, plus two Aleve. (Ask your doctor before taking any migraine medication). In the end I did not experience much of a headache at all; just the visual aura.

One morning few years ago I woke up with a migraine headache, which had never happened before. Since I wasn't able to take medication before the pain began, it was especially severe. On this occasion my right eye's central vision loss never entirely recovered, and remains impaired to this day. If I look at a thin horizontal line with my right eye--such as a telephone wire--there is a small "dip" or blurred-out spot in the center of my visual field. Many doctors have looked into this eye with their instruments, but none can see anything wrong. Either the problem is too small to detect, or it has nothing to do with the eye at all.

There is some evidence that migraines may cause actual brain damage, and that sufferers who see auras in particular are more prone to having strokes in later years. So I take this quite seriously and do everything possible to prevent them from occurring, or ease their impact when they do occur.

"Migraines are a kind of mild epileptic seizure," said Steve Lehar, "where the cortex gets electrically active by positive feedback until it is saturated, activity wise, and after a while it gets exhausted and goes quiet. If this same 'seizure' happens in one's motor cortex, then the body starts to wrythe, with patterns of contraction and relaxation; whereas if it occurs in the auditory cortex one hears hallucinated sounds. But if the seizure happens in the limbic system (hippocampus) then one will get intense religious experiences, like Saul who fell off his horse and saw God, which made him change his name to Paul and join Jesus instead of persecuting him! And Joan of Arc, who would hear God's voice telling her to fight against the English."

Wouldn't it be ironic if migraine headaches were responsible for all of the religions of the world?
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Thanks to Steve Lehar for his comments, and for providing the following links:

Visual hallucinations of line form dimension

Scintillating scotoma

Migraine description