Full Question:
I’m a male in my mid 20’s who has been diagnosed with acephalgic migraine with aura. Unfortunately for me my primary trigger is one from which I cannot seem to escape, fluorescent lighting. By training I’m a biomedical researcher and laboratories are synonymous with fluorescent light bulbs… somewhat problematic, especially given that I absolutely love what I’m trained do.
I’m under the care of an extremely reputable headache specialist, who has been nothing but supportive and whom I trust. Unfortunately I’ve had difficulty getting a straight answer to a question of mine that, through this process of trying different preventative medications and putting off graduate school, has gradually been taking on greater importance. So here is my question. As a general rule of thumb does this type of migraine (or maybe more importantly, does this trigger) respond just as well to prophylactic treatments as a more standard migraine presentation or has your experience shown it to be more treatment refractory?
Thank you in advance for your reply, Pat.
Full Answer:
Dear Pat;
This is an difficult problem to deal with. Changing your ambient lighting from fluorescent to otherwise might help. Not always possible in the workplace. I’m sure you tried dark glasses, etc. Lamictal has been shown to help with auras in migraines even when the migraines are not disabling. The problem here would seem to be that it's not an occasional or transient trigger, but one that's present for your entire work day. I know of no data on this question, but it would seem logical that it may be harder to prevent Migraines that are triggered by an environmental trigger that you're exposed to for such long periods of time.
It might help if at least part of your work day could be spent outside of fluorescent lighting. Examine your work day, looking for tasks that can be done in areas where fluorescent lighting could be changed out. Employers are required under the Americans with Disabilities Act to make "reasonable accommodations."
One last thought, simple, but possibly helpful. Have you tried a combination of sunglasses with polarized lenses and a cap with a visor or a sun visor? The addition of the visor could block the fluorescent flicker from hitting your eyes from above the glasses.
Good luck,
John Claude Krusz and Teri Robert
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Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.
