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Old 02-15-2011, 11:13 PM   #11
Scott Alexander
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Re: Ophthalmic Migraines

Andrew,

I get ocular migraines after intense workouts. In fact, I got one tonight about an hour after finishing my WOD. Mine are fairly infrequent and usually occur several hours to a day after the precipitating workout. I had my first one in high school and get one about every six months or so. Unfortunately, as I'm pushing myself harder through Crossfit, they are happening more often.

After getting checked out by an ophthalmologist, I was told that everything was okay. I have not gotten an MRI or neurological testing to rule out aneurysms or other neurological disorders.

I work in the medical industry and so I've done some research on the subject. The info lines up well with my experiences for what happens to me, but since I'm not a doctor, I wouldn't take it as necessarily right for you.

For folks under the age of 40 presenting with bilateral visual disturbances (mine is like I looked into a bright light), ocular migraines are the most common diagnosis. Their cause is not clearly understood, but it is believed that it may be tied to vasodilation and vasoconstriction caused by your trigger (blood vessels expanding or constricting due to exercise in my case). Usually pain following an ocular migraine is nil or mild. This is different than a migraine with aura, where the pain can be severe. (tish, it sounds like this is more in line with what your daughter has.) This is important because the cause of the two kinds of migraine is believed to be potentially different in some cases. At least one paper I read concluded that there does not appear to be any long-lasting effects associated with ocular migraines, like an increased risk of stroke or blindness. If you want that paper, I could probably track it back down.

So, for me it appears that these roughly hour long periods of visual disturbances is just the price i pay when I push myself more than I should. I would recommend trying to pinpoint the triggers (really pushing yourself when you are dehydrated, for example) and avoiding them to the extent possible.

Good luck,
Scott
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Old 02-15-2011, 11:17 PM   #12
Scott Alexander
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Re: Ophthalmic Migraines

Correction to my previous post:

My post should have said that ocular migraine is the most common diagnosis for people under the age of 40 with bilateral visual disturbances and little or no residual pain.

I'm typing on an iPad and for some reason i couldn't edit my post once I saw my error. Sorry for any confusion.

Scott
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Old 02-16-2011, 08:44 AM   #13
Arturo Garcia
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Re: Ophthalmic Migraines

Late in december, after a very tough WOD, I had this huge pain in what felt like my left eye. Behind it, or something like that. I layed down for quite a while but the pain was HUGE. I attributed it that time to having worked out only about 1.5 hours after a big breakfast. I had nausea and I was feeling so bad that I stuck my finger in my throat to vomit. Like 3 times. The headache lasted like 3 hours. This was the very first time it happened so I just said "ok, no working out if I'm not feeling an empty stomach again".

But about 2 weeks ago, on a monday noon, having not worked out since friday, I got the same pain during lunch. I forced my vision a little bit right before the pain, as I forgot my glasses and was reading a laptop from a bad angle. Maybe this triggered it. It lasted for hours. The pain was horrible, I got nausea again and used my hands again to vomit. Went to an eye doctor who said everything is fine and it was stress-related..!? I guess I gotta take things easier or something? Migraines... I had never experienced one before this.

I didn't see any lights and oddly enough my vision was not bad. Interesting to read about you guys and girls.
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Old 02-16-2011, 01:43 PM   #14
Rick Hardin
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Re: Ophthalmic Migraines

My wife gets them with the aura, after lots of documenting and some research we figured out hers are tied directly to her blood sugar.

If she catches it fast enough a piece of cheese or glass of milk will stop one.
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Old 02-17-2011, 09:52 AM   #15
Lenora Galitz-Pfeffer
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Re: Ophthalmic Migraines

I have had these a few times - shimmering with both eyes. In a couple of them, I recall having been dehydrated. In a couple of others I was stressed. It lasted anywhere from a half hour to an hour, and didn't result in pain.
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Old 02-17-2011, 03:54 PM   #16
Becca Borawski
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Re: Ophthalmic Migraines

Ugh, I get migraines, too -- these days they usually start with the visual disturbances, when I was younger they started with my fingers and toes going numb, or with an inability to speak properly (like the poor lady on the morning show!).

Certain workouts are more likely to trigger them for me -- large amounts of pull ups, push ups, and exercises activating my neck and traps always make me nervous. I have learned to use the lacrosse ball to really dig into those muscles after a workout and it helps.

Sleep and hydration also make a big difference.

Sometimes they just happen, though, for no good reason.

I wrote a personal essay about them recently, actually, on my blog:

http://nerdjockprincess.com/?p=42
(work/family safe)
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Old 02-18-2011, 02:06 PM   #17
Darrell E. White
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Re: Ophthalmic Migraines

Hi folks. Thought I would make one of my recently infrequent visits here. Lo and behold, a topic I know a bit about. The following is meant to be for general informational purposes and should not be construed as medical advice, diagnosis, or prescription. For that please consult you personal physician.

Migraine actually represents a continuum of symptoms. It is thought to be a vascular phenomenon wherein the process begins with a vasoconstriction somewhere in the central nervous system. This is then followed by a dilation. The degree and location of the vascular activity determines the symptoms.

A "Classic Migraine" involves a prodrome or warning symptom. In the case of this thread, and in my profession (ophthalmology) that symptom is visual. This is caused by the vasoconstriction. If the blood vessels then dilate to their normal caliber the migraine is over. An "Ophthalmic Migraine", warning symptoms without the headache. If a headache occurs after the vision change it is a full-blown "Classic Migraine".

The symptom scenario described, prodrome followed by headache, is migraine by an overwhelming percentage at all ages. While uncomfortable it is benign in all but the most rare of circumstances associated with severe vasoconstriction. The symptoms are not indicative of other pathology, and scans come up normal >99.99% of the time in this setting.

Both Ophthalmic and Classic migraines, as well as migraines without a prodrome can be triggered. Foods, fatigue, stress, lack of sleep, etc. are classic, but a significant % have no definable trigger. For some an intense WOD could be a trigger.

Treatment for infrequent episodes is palliative. Very frequent, debilitating migraines are treated with avoidance of triggers (aged cheese and chocolate for me), and with medicines if necessary.

Hope that is helpful.

--bingo
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