It starts as a streak of light, then makes its way through my vision

TheE. Ashdown was at the bar having a quiet drink after work when he suddenly looked at him and couldn’t see half of his friend’s face. “I assumed I was having a lot of drinks because I felt completely disoriented.” He quickly made his excuses and left, and went straight to bed when he got home.

But the distorted vision recurred and soon settled into a pattern. “It starts as a vague streak of light in the lower corner of both eyes and works its way through my field of vision over an hour,” says the 37-year-old auditor from Heathfield, East Sussex. Then it slowly disappears in the upper corners. That’s when the headache starts.”

A few months later, he went to see his doctor, who told him these were migraine auras. Migraines affect about 10% of the population in the UK, according to the National Migraine Centre. One in three of these people will experience auras. Confusingly to anyone who equates migraines with pain, auras sometimes appear without a headache; These are known as “silent migraines.”

Auras can be visible — usually in the form of flashing lights, zigzag patterns or blind spots — but they can also include other symptoms such as ringing in your ears, pins and needles, fancy smells, or aphasia, in which a person temporarily loses the ability to speak or understand talk of others.

Many sufferers worry that they are having a transient ischemic attack (TIA), also known as a mini-stroke. However, migraine aura symptoms tend to be “positive” (such as flashing lights and skin tingling) and develop very slowly, while TIA symptoms are more likely to be “negative” (loss of feeling in your hands or seeing in one eye, although example) and come suddenly.

Zoe, 27, has had migraines since she was nine. “I get squiggly lines. It’s the same colors every time – strong blues, pinks, yellows, blacks.” Each aura will last for two to four hours, with severe headaches starting as they support.

“I also feel tingling and needles, difficulty speaking, loss of feeling in my hands and legs…Sometimes it’s so bad, I can’t even walk.” She also suffers from tinnitus during these attacks. “I got sizzling sounds like there were bees or wasps circling around my head.”

Zoe, a court administrator who lives in Leeds, has been having problems at work due to the amount of time she has to spend, as she suffers from up to 20 migraine auras a month. (MRI ruled out other causes.) They also meant that she had to pull out of friends’ birthday parties at the last minute and miss important family events. “It only has a negative effect, it’s not being able to leave the house or do anything,” she says. “I was suffering from depression at some point.”

Migraine auras result from something known as cortical diffuse depression: a wave of electrical activity traveling through the brain’s cortex. Dr Mark Weatherall, a consultant neurologist at Stoke Mandeville Hospital in Buckinghamshire and chair of the British Association for the Study of Headache, compares it to “a small tsunami, a wave of hyperactivity followed by a decrease in activity”.

He adds that these occur automatically and efficiently in the visual part of the brain, and are harmless. “As this wave propagates across the surface of the brain, every part of the visible part of the brain is hit. Hyperactivity causes flashing lights or zigzags, and then you get a period of inactivity, and that’s where the blind spots appear. Ultimately that’s clear.”

For most people with migraine auras, “all they need is rest and let them pass,” Dr. Weatherall says. There are no treatments available for auras, only headaches. Mild pain can be controlled with over-the-counter pain relievers such as ibuprofen, paracetamol, and aspirin. Research has shown that supplements such as magnesium and vitamin B2 can help prevent migraines, while coenzyme Q10 reduces the duration of an attack and ginger helps relieve pain and nausea.

For more severe attacks, triptans, anti-inflammatory and anti-nausea medications may be prescribed by your GP to control any nausea and pain. Beta-blockers, antidepressants, and anti-seizure medications are also used to reduce the frequency of migraine attacks.

Identifying personal triggers can be helpful. Dr. Don Sim, a consultant ophthalmologist at Moorfields Eye Hospital and co-founder of eye health brand MTHK, patients often come to see her with migraine auras, worried that something is wrong with their vision. After a thorough eye exam to rule out any other conditions, you sit down with them to find out what their triggers are.

“Lack of sleep, and caffeine, and chocolate, and tea, and cheese, and red wine… I lift these things up for people and they say, ‘Oh, so all the good things in life?’” “You have to identify your trigger. If excess consumption or any small piece of cheese is what you start with, in this case, you should try to exclude it from your diet. If it is [auras] Without headaches, they tend not to affect people’s lives.” For people who also have debilitating migraines, she refers them to their GP or neurologist.

Kim Oliver in front of a visually dissonant mural.
Kim Oliver who retired from her job due to a migraine. Photo: Christopher Tommond/The Guardian

“My food intolerance is ham and cheese,” says Kim Oliver, 50, of Liverpool, who has medically retired from her job as a religious staff member due to migraines. She started having migraines in 2006. “Bacon, sausage, paté—all my stuff—within 20 minutes of eating it, I’m out.”

A 2007 US study of more than 1,200 people with severe migraines found that nearly 80% of participants considered stress a major factor. Other triggers include hormones in women, hunger, sleep disturbances, odors, neck pain, alcohol, smoking, heat, light, food, exercise, and sexual activity.

A little more than 53% also indicated that weather played a role, which seems to be true for Oliver. “When it’s overcast and raining, these are the worst times for me,” she says. For Zoe, too, he seems to be the most consistent catalyst. Its attacks can go off if it’s “wet or humid, or if it’s cold and then all of a sudden it’s too hot.” Ashdown agrees: “The only thing I can think of that seems to relate to getting these things is when it’s really windy.”

Migraines, especially migraines with auras, are associated with a slightly higher risk of death from cardiovascular disease. But Dr. Weatherall stresses that there is no need to panic. “The vast majority of people who get migraines will not have consequences.” Likewise, he says, “No one has ever done a study showing that if you reduce the frequency of migraines, you reduce your risk of heart disease or stroke.”

As for Ashdown, he still calls for a cure, after nearly 20 years of misery and countless tests to see if there are any underlying issues. He wasted many days in a dark room waiting for his migraines to pass.

“I can make peace with them if I know when they’re going to happen. It’s ignorance. I have to organize a stag party for my friend. If I go out and get one, what do I do? I hope something comes along one day that can stop them.”

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