Severe symptoms, aura and pain for months. Migraine?

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    I'm writing today because I've been experiencing some severe symptoms that came on suddenly months ago. The most bothersome symptoms are intense pain in the head, face and neck and visual disturbances. Some of the visual disturbances are blurriness, visual snow, persisting after images, whiting out, flickering and flashing. The flashing can be at the edges of my vision or it can be like a strobe light going off. After a trip to the ER, the nurses told me that I was having migraines, but I'm not convinced because I've only had four or five migraines in my life and the pain I'm feeling doesn't feel like migraine pain. The pain is spread over my whole head and there are other varying types of pain that happen along with it. Sometimes sharp, burning, pressure or sudden intense pains. My visual symptoms have been almost constant for over five months. If these disturbances were migraine aura, is it possible that they could last continuously for months with pain in the head that also has not gone away for the same amount of time?


    Thank you so much for this form and for being willing to answer questions like these. Any information you could share with me would really mean a lot and I sincerely appreciate any answers someone might be able to give me about this. Max.


    Full Answer:

    Dear Max;

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    Thanks for your question, and you're most welcome. ER staff usually tell patients to follow up with their own doctors because it's their job to get us out of any emergency state we're in, the our regular doctors take it from there. So, we have some questions - Did you follow up with your doctor. You mention previous migraines. Were you diagnosed with migraine by a doctor, or self-diagnose from your symptoms. We tell you the questions we have so you know the questions we have in mind as we give you some information.


    The visual symptoms you list can be attributed to migraine aura. Only a doctor who can review your medical history and family medical history, discuss your symptoms with you, and examine you in person can tell you if they're migraine aura in your case, but we can tell you that they're typical migraine aura symptoms. You can find more information on aura in Migraine Aura Can Have Many Variations and 19 Less Often Discussed Migraine Aura Symptoms. Although aura symptoms should fully resolve after a migraine attack, there is a form of aura called persistent aura without infarction, which is aura symptoms lasting a week or longer with no evidence of stroke or TIA on imaging studies. This is rare, but it does occur.


    You're correct that the pain you describe isn't typical of migraine, but it's possible that it's migraine. It's also possible that you have more than one headache disorder. For example, it's not unusual for people with migraine to also have ice pick headaches, which might explain the sudden intense pains you mentioned. You can find more information on ice pick headaches in Ice Pick Headaches - The Basics.


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    A single migraine usually lasts two to 72 hours. Some do last longer; some do actually last for months. That said, yours is an unusual presentation with both aura symptoms and headache continuing for so long. The rule of thumb in treating migraine is that when a migraine goes beyond 72 hours, the migraineur should contact their doctor.


    We're happy to have this discussion with you and offer you information that you can also discuss with your doctor. Beyond that, the help you need must come from a doctor who can review your personal and family medical history with you, discuss your symptoms with you, and examine you in person. If your doctor isn't able to help you, it may well be time to consult a Migraine and headache specialist. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, see Migraine and Headache Specialist Listings.


    Hoping you find your answers soon,
    David Watson, MD, and Teri Robert


    About Ask the Clinician:

    Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. He and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Watson or more about Teri Robert.


    If you have a question, please click HERE. Accepted questions will be answered by publishing the answers here. Due to the number of questions submitted, no questions will be answered privately, and questions will be accepted only when submitted via THIS FORM. Please do not submit questions via email, private message, or blog comments. Thank you.


    Please note: We cannot diagnose, suggest specific treatment, or handle emergencies via the Internet. Please do not ask us to diagnose; see your physician for diagnosis. For an overview of how we can help and questions we can and can't answer, please see Seeking Migraine and Headache Diagnoses and Medical Advice.


    We hope you find this general medical and health information useful, but this Q & A is meant to support not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.


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    Last updated October 1, 2014.



Published On: October 01, 2014