Migraine aura anyone? Or does the cheese stand alone?

[johnmarkos]

Interesting article about migraine, by Katherine Foxhall in History Today. https://www.historytoday.com/archive/feature/misery-head

My migraines are the classical type, with the aura. I'm also often depressed or anxious (very different from my chipper emotional set point) in the 24-48 hours before I get one, and sometimes I get a backache, too.

And then, once I treat the migraine, I sometimes feel euphoric, but maybe that's the caffeine.

 

[NurseRatched]

I have been wondering about the possibility of tiny flecks of calcium breaking off from a calcific valve and traveling to the tiniest blood vessels in the brain, causing the aura so many of us have pre- and post- valve replacement. That would explain why there is a spike in severity of symptoms post valve replacement from the effects of valve manipulation and being on the heart-lung machine. We all have vascular issues or else we wouldn't be on this site, so it only makes sense that many of us have migraines. Could we all be having tiny TIAs or ministrokes with transient speech issues, temporary numbness, the grey curtain, brain fog, etc. There is such a thing as CPPD (calcium pyrophosphate dihydrate) crystal deposition disease, a problem with calcium metabolism. Also causes gout (deposits in joints) and inflammation and the sequelae of all that, including osteoarthritis, kidney stones, Alzheimer's dementia, etc. I, too, am convinced the physicians are aware of the connections, but since there's no "cure" for the natural aging process, they prefer to brush it off, hoping to minimize our anxiety. I think that approach actually exacerbates it.

 

[Protimenow]

Hey, Nurse -- you've been monitoring this for two years (happy anniversary, BTW) and only posted twice?

Your theory is interesting - but if the issue is one of tiny flecks of calcium breaking off -- couldn't they wind up almost anywhere in the brain? If there's no specific area for them to deposit (and cause the migraine-associated events), wouldn't these be associated with a lot of unrelated events? Or could it be that there's a specific area (because of vascular geometry in the brain) where they get caught - and the symptoms disappear once blood flow dislodges them?

But, if that's the case, why is it that unexpected bright lights can trigger auras; in some people hunger is an apparent trigger; and for many of us, we don't have a clue WHAT triggers them. Why is it that shielding the eyes from bright light during these episodes seems to help? Why do chocolate, and sometimes caffeine, seem to shorten the events?

Although these are sort of random, there DO seem to be triggers - is there something in the triggers that causes the calcium flecks to go from heart to brain?

Yours is an interesting theory, but I'm not sure that it's supported by evidence -- especially because triggers seem to make it non-random.

 

[johnmarkos]

It seems to be related to allergies for me -- that is, when the pollen count is high, I'm more likely to get a migraine. Also, I sometimes get them when I'm about to get a cold.

But, if that's the case, why is it that unexpected bright lights can trigger auras; in some people hunger is an apparent trigger; and for many of us, we don't have a clue WHAT triggers them. Why is it that shielding the eyes from bright light during these episodes seems to help? Why do chocolate, and sometimes caffeine, seem to shorten the events?

 

[bizinsider]

I have been wondering about the possibility of tiny flecks of calcium breaking off from a calcific valve and traveling to the tiniest blood vessels in the brain, causing the aura so many of us have pre- and post- valve replacement. That would explain why there is a spike in severity of symptoms post valve replacement from the effects of valve manipulation and being on the heart-lung machine. We all have vascular issues or else we wouldn't be on this site, so it only makes sense that many of us have migraines. Could we all be having tiny TIAs or ministrokes with transient speech issues, temporary numbness, the grey curtain, brain fog, etc. There is such a thing as CPPD (calcium pyrophosphate dihydrate) crystal deposition disease, a problem with calcium metabolism. Also causes gout (deposits in joints) and inflammation and the sequelae of all that, including osteoarthritis, kidney stones, Alzheimer's dementia, etc. I, too, am convinced the physicians are aware of the connections, but since there's no "cure" for the natural aging process, they prefer to brush it off, hoping to minimize our anxiety. I think that approach actually exacerbates it.

Nurse, I love this theory. The only quibble I would have in this is that my valve is not seriously stenotic and based not the echos there isn't a ton of calcium (not to say you need a lot for your theory to work) but mine started in my 20s, when I probably had none and now I'm 67. My frequency, as I've written here previously, has kicked up dramatically in recent months – along with the size of my sinus/valsalvus. I mentioned that during a phone consult with a surgeon yesterday (Luis Castro in the Bay Area) and he mentioned something about electrical currents that cross the heart - that could be somewhat related. (B/c it was an initial phone consult I did not want to press further, so wasn't quite sure where he was going with that.) And as I've mentioned, if you Google ocular migraines there are very recent studies suggesting they can be tied to a-fib and strokes. I'd say, based on reading these and other valve-related forums for years, they are somehow tied to valve issues. I'm not sure that has ever been studied. Would it be related to stenotic valves? Could be. Thanks for sharing your thoughts on this.

 

[Agian]

Unlikely. if a piece of calcium lodges somewhere, it's unlikely to budge in a jiffy. There would be nothing 'transient' about such an event.

 

[workmonkey]

Nurse, I love this theory. The only quibble I would have in this is that my valve is not seriously stenotic and based not the echos there isn't a ton of calcium (not to say you need a lot for your theory to work) but mine started in my 20s, when I probably had none and now I'm 67. My frequency, as I've written here previously, has kicked up dramatically in recent months – along with the size of my sinus/valsalvus. I mentioned that during a phone consult with a surgeon yesterday (Luis Castro in the Bay Area) and he mentioned something about electrical currents that cross the heart - that could be somewhat related. (B/c it was an initial phone consult I did not want to press further, so wasn't quite sure where he was going with that.) And as I've mentioned, if you Google ocular migraines there are very recent studies suggesting they can be tied to a-fib and strokes. I'd say, based on reading these and other valve-related forums for years, they are somehow tied to valve issues. I'm not sure that has ever been studied. Would it be related to stenotic valves? Could be. Thanks for sharing your thoughts on this.

These are interesting theories. The calcium deposit theory is supported by the only suggested explanation I ever got from a doctor, who said that the clamping of your aorta during connection to a heart/lung machine can loosen debris (not just calcium, but plaque, etc) which slips through the mesh screen, and then travels through the circulatory system to get lodged in smaller vessels. Perhaps the first place it reaches is in the visual cortex? And triggers are anything that "inflame" that area (bright lights? exercise?) and migraines result from impaired blood flow? Also, I had my first experiences with gout after my surgery, having never experienced that before, which would support this. This is all just arm chair speculation.

The electrical currents suggestion is interesting as well - This would draw a direct link between the electrical synapses in the brain and the heart ... I'm just winging it here, but perhaps when they restart your heart, it creates an electrical surge of sorts that impacts some receptors in your brain, making them more sensitive? Or the changed current of the heart, after surgery, creates a link. This is just anecdotal, but my migraine symptoms often have an "electrical" quality to them, as if struck by lightning (numbness in nerves, flashing lights, a feeling of static in my brain) ...

Obviously, answering this would take tons of research, and because these migraines are deemed unserious, it seems they have no interest in pursuing it. Which is unfortunate, as it definitely affects the quality of life, especially in the immediate years after surgery.

 

[Protimenow]

Many of us here beginning long before surgery. In my case, it was seven years before a medical student heard the murmur, and tests determined that I had a bad valve.

I'm curious about whether the emergence of the optical migraines could be suggestive (if not diagnostic) of heart valve issues -- a symptom -- that may be enough to do further testing to rule out a bad valve. OTOH -- even if a bad valve is detected, it may be decades before the valve needs replacement,or, with the current progress in valve device development, whether or not it's of much value to know that, eventually, some intervention may be necessary.

 

[NealR]

I had the om's after my first ohs.. Eventually, I figured out what they were and simply ignored them knowing they go away in about 20 minutes. I had a 2nd ohs, (about 10 years later-"same two valves replaced), but experiences no om's..at least to this point, 7 mos post surgery.. Who really knows

 

[doclewis]

I have had same symptom since adolescence, only difference is the frequency. Most who have posted here relate same time frame. As with protime, I had auras long before heart trouble detected on echo. In my case over forty years. Why wouldn't calcium get better after valve replaced rather than worse. I could see them getting worse immediately after surgery, but why would it be persistent for years. Seems like most who have posted here have had aortic valve surgery and others have posted that they wonder about association of bicuspid aortic valve with migraines. I also think about the association between migraines and aortic valve disease, but again wonder why it would get worse after surgery rather than better if it was cause and effect.

 

[bizinsider]

Many of us here beginning long before surgery. In my case, it was seven years before a medical student heard the murmur, and tests determined that I had a bad valve.

I'm curious about whether the emergence of the optical migraines could be suggestive (if not diagnostic) of heart valve issues -- a symptom -- that may be enough to do further testing to rule out a bad valve.

Based on personal experience and the volumes I've read on these forums and others, I would think, as they say...it couldn't hurt! I would love to see a study. Sadly, it probably would not be conclusive and, in the end, would be probably be an indicator for some people. One question I would have: How many people who had dissections of the aorta related to a bicuspid valve - and who didn't know they had a bicuspid valve and, thus, an inflated aorta - had ocular migraines?

 

[KSS]

Yep! Have had them for decades (before & after OHS). My father had them too. One dr told him it was caused by a sudden drop in blood pressure.

 

[sylviayasgur]

Funny, although my husband is the patient here, I have had several ocular migraines in the last two years. I wasn’t sure what they were until my opthamologist diagnosed them. No headache, just visual zig zags and impairment for 20-45 min.

 

[Protimenow]

Sylvia -- I'm just a bit curious here -- have you ever had a cardiac echo or an exam that was more rigorous than listening to your heart with a stethoscope?

Is it possible that you may have a minimal valve issue that hasn't been diagnosed.

 

[doclewis]

It has been almost a year since I have been to this website. I have posted several times regarding these silent migraines or ocular migraines or aura without migraine. Briefly had these since adolescence with no headache since 30's. Now 76. 5 years post AVR with Edwards bovine valve. Marked increase in frequency of migraines after surgery. Initially 2-3 a week now 2-3 a month. No improvement in frequency past year. I think that I feel better than I used to for the day or two after an episode. Previously felt depressed and fatigued after spell for a day or two but haven't noticed this lately. This is only problem I have had post op. Never have found anything that seems to help with frequency. Posting to see what others who have posted on this thread are experiencing. Specifically previous posts have suggested cannibus oil. Is frequency lessening? These spells bother me, maybe more than they should. I have cut way back on my exercise as I thought they were related, but I have to keep moving at my age or I will never be able to do anything.

 

[pellicle]

Specifically previous posts have suggested cannibus oil. Is

myself I found that chiropractic helped me. I found that when I worked at a desk (IT) if I didn't have chiropractic I'd ramp up to getting them weekly, when I did I'd go months or even years without them. I have since found myself how to mitigate it without seeing a chiro and its by keeping my neck and shoulder area mobile and in good posture.

Posture and tension seems to be a significant trigger for me.

I found that wearing a backpack to carry groceries and whatnot promotes a better stance, cycling and a light weight routine that focues also on shoulders and neck (and interestingly light high rep bench press (specifically NOT machine) too. Light in my case is my warmup and I can feel my neck freeing up and moving, I do this twice daily.

 

[Katerina Winchowska]

Pre-op ten years ago I had gradually decreasing instances of classic migraine, down to maybe two or three a year post menopause. Post-op I now have increased frequency, on average five per month, of visual migraines, with the neon light shows, but no headache. Only twice have a had accompanying headache. Once the day after surgery and the other following an eye examination with high resolution tomography, both equally severe. Migraines last about 20 mins to half an hour and there is no warning. I have more or less given up driving because of this. Both GPs and cardiologists tell me this is nothing to do with having OHS. I don't believe it. I think my visual migraines are mostly triggered by bright lights, flicker or strong sunlight.

 

[Protimenow]

For me, bright light can be a trigger for ocular events. It helps to get out of the light if I'm having ocular migraines.

I'll try to fix my posture - I have some 'posture corrector' things that pull my shoulders back, reducing the slouch that Pellicle said may have increased the frequency of his ocular events.

I started getting ocular migraines when I was 16 years old. I had my OHS when I was 41.

Although I infrequently get them, I still drive. I suspect that there are probably very few of us who have stopped driving because of these infrequent events. You can always get off the road until the things stop - and you should be able to safely pull to the side of the road when the ocular migraine starts. You can probably also drive while having the event - if I am driving when I have an event - and can't get off the road - I can see around the shimmering lights to still safely drive and navigate - but, of course, it's still probably best to get off the road - maybe stop at a store or drive through for a coffee (caffeine is supposed to help), or chocolate shake (chocolate is also supposed to help). For me, years ago, a pepsi and Milky Way bar reduced these things from a half hour to 30 minutes or so (actually, once or twice, it actually stopped the event almost immediately).

 

[Freebird]

I started having ocular migraines (without pain) a couple years ago, before surgery, but you could also argue they started around menopause. Some think it's related to hormones.
Shortly after surgery in late August they increased, as did my sensitivity to light. I'm now 10 weeks post-op and off of the beta blocker. My light sensitivity seems to have decreased.
Other theories I've heard are that they're related to low blood pressure, which would make the post-surgery increase logical since the beta blockers sometimes kept my bp too low.
Another theory I heard is to supplement with vitamin B12. So I've decided to throw $5 at the problem and take B12. So far so good, but I've yet to hit the 21 days without an ocular migraine mark.
I've asked every sort of doctor who will listen; primary care physician, cardiologist, surgeon, and optometrist, and none of them provide causes or seem concerned.

 

[doclewis]

Freebird, My experience is remarkably similar to yours. I was on beta blocker preop for aneurysm. Post op it was decreased because blood pressure too low. Beta blockers are a medication sometimes recommended for frequent migraines so I went back up on the dosage but it has not made any difference one way or the other. I also have discussed with all the types of doctors I have seen with no suggestions. My longest spell without one is 30 days, but still have weeks with two or even three. Sunlight does seem to sometimes cause one. I was certain that exercise brought them on. Still feel that it is a factor. I cut way back on how fast I walk and how far. I do walk on the beach so usually sun is a factor. When I try to speed up my walk and go full five miles, definitely causes one, but not every time. Now always take water when I walk and wear sunglasses when sun is out. I have also noticed several while sitting at computer with blinds open and sun shining. Since I had these preop maybe once every three months and postop several a week, I too am certain they are related to surgery. Will think about posture as recommended by pellicle and protime. Your experiences very similar to mine reassure me Thanks