"Ocular Migraine" - Not, and Why Not

Patient Expert

The members of our community here at MyMigraineConnection.com  seek current, correct, compassionate information and support. That's what I love about being part of it - everyone gets to help one another with care and encouragement.  I especially enjoy being able to bring you updated tidbits when I come back from scientific headache and Migraine conferences. What I don't like seeing is information "out there" on other web sites about Migraine disease and headache disorders that isn't accurate.

Recently, a piece on "ocular" Migraines caught my attention. Let me first say it had some good points. For instance, Migraines can be triggered by certain foods such as aged cheeses, caffeine and MSG. There are certainly plenty of other food and non-food  triggers such as; red wine, nitrates, hormonal fluctuations, weather changes, and inconsistent sleep schedules. Recognizing and managing our triggers is one important step we can take to help combat our Migraines. We have a  free Migraine diary  you can download as an accompanying tool to our article Your Migraine and Headache Diary. If you need help identifying food triggers, you can find information and a free downloadable food trigger workbook in _Managing Migraine - Migraine Trigger Foods _.

Some not-so-good information in the blog talks about how visual symptoms of a Migraine "are related to activity in the visual cortex in the back of the brain. If you experience an ocular migraine take safety steps immediately." Ummm, what? The visual cortex is in our occipital lobe and connected to our eyes by our optic nerves. We don't know that aura or its symptoms have anything to do with the visual cortex, but maybe future studies will reveal different information. On the other hand, cortical spreading depression may affect Migraine aura  and there may be neurophysiological events where visual or sensory symptoms  can result in activation of trigeminal/cervical nociceptive neurons.  On the  "immediate safety steps," mentioned in the blog, driving while you have a Migraine is a bad idea because your reaction time  is reduced, your vision may be blurry and you may be nausea and vomit  if indeed  these  some of your  Migraine symptoms. Pathways of a Migraine  will show you what we think are the steps involved in a Migraine attack.

"Ocular" Migraine is used by different people to describe different things. I know, I know; your doctor has told you over and over again that you have this type of Migraine. But really, you may have 'Migraine with aura'; or 'typical aura with Migraine headache'; or 'typical aura with non-Migraine headache'; or 'typical aura without headache'; or _'Retinal Migraine' _. That's a lot of different Migraine types and/or headache types It's a bit confusing I know, but these are all diagnostic terms that The International Headache Society's International Classification of Headache Disorders, second edition (ICHD-II) has in place for Migraine specialists and doctors to use. If everyone were to use this classification system it would make things easier for patients and doctors alike.

Now back to accuracy.  When given the diagnosis of "ocular" Migraine, what are we to do? It is not listed in the ICHD-II, and self-diagnosis is not a good idea under any circumstances.  Getting accurate information, having a good relationship with doctors, and trying to keep good records is. So having the right diagnosis is the first step. This gives our doctor a starting point for treatment and allows us to receive the right treatment when traveling. How do we do that? By having our doctor do an exam  who will  go over our medical history, symptoms and do a full neurological workup.  Then we can  find the most  current, reliable, information there is on whatever diagnosis the doctor gives us. To get you started take a look at this article; _Ocular, Optical, and Ophthalmic Migraines _ may help dispel the misconceptions some of us have about "ocular" Migraine.

When I began writing this post, one of the  real problems with the blog was that they said there is no treatment for it. Now, the last paragraph reads,

"If you begin to experience these migraines on a more frequent basis or if they begin to interfere with your daily functioning, you should see your doctor to see if there is a medication you can take to reduce the frequency of the problem. Some people have reported that taking vitamin B12 has helped reduce the incidence of the ocular migraine. This has not been proven in medical trials but it is worth a try to see if this helps you control the frequency of occurrence."

I'm sure it seems to some that I'm being "picky" here, but let me assure you that there are reasons for using and looking for current and correct diagnostic terms:

  • When we come across information on line that uses incorrect diagnostic terms, it stands to reason that we shouldn't readily accept the information on their site as being accurate.
  • If everyone uses whatever diagnostic terms they want, however they want, it will only result in confusion. For example: We see the term "ocular Migraine" used fairly frequently, BUT we also see it with all kinds of different descriptions and information. There's just no way to know what may or may not be even remotely accurate.
  • In the end, we all want the best, most accurate information we can find.

If you want to know more about why this is important, take a look at the article _The Type of Migraine Does Matter _.


Migraine Symptoms Guide What is an Ocular Migraine?  January 20, 2010.

The International Headache Society. "International Classification of Headache Disorders, 2nd Edition." Cephalalgia, Volume 24 Issue s1. May, 2004. doi:10.1111/j.1468-2982.2003.00823.x

Pathophysiology of Migraine. Hadjikhani N, Sanchez Del Rio M, Wu O, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA. 2001;98(8):4687-4692.


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