For most people, the term "migraine" is associated with an excruciating headache. However, few people know that some forms of this disease can be accompanied by visual disorders. This type of pathology is called ophthalmic migraine or atrial scotoma. Neurologists do not distinguish it as a separate disease. This is just a form of the usual migraine, which occurs not only with a headache, but also with visual disturbances. Spots (scotomas) appear before the eyes, covering the field of view, bright flashes, luminous figures. Next, we will take a closer look at the causes and treatment of ophthalmic migraine.
Mechanism of disease progression
In the back of the brain is the visual analyzer. It is responsible for the correct perception of the surrounding world by the eye. Under the influence of various unfavorable factors, a temporary circulatory disorder in the analyzer area may pass. itleads to visual distortion. Such violations cause an attack of ophthalmic migraine.
Most often, patients associate the appearance of spots before the eyes with vision problems. But in this case, the cause of the pathology lies solely in neurological problems. No ophthalmic pathologies are detected in this case.
Provoking factors
What can cause circulatory disorders in the visual part of the brain? The following causes of ophthalmic migraine can be distinguished:
- bad dream;
- overwork;
- oxygen deficiency;
- hormonal disorders;
- vascular pathologies of the brain;
- drinking and smoking;
- excessive exercise;
- stress;
- frequent climate change;
- taking certain medications;
- abuse of coffee and chocolate;
- flickering lighting and strong indoor odors.
Among doctors, there is an opinion that this pathology occurs due to a hereditary predisposition. However, official science does not confirm this.
Risk group
Ophthalmic migraine is much more common in women than in men. Pathology is more often observed at a young age - from 20 to 40 years. Elderly people rarely suffer from this disease.
This form of migraine is common among teenage girls. This is due to the fact that hormonal changes occur in the body during puberty, which can provoke neurological disorders.
Ocular migraine attacks often occur in pregnant women. This is also associated with hormonal changes in the body.
Disease forms
Let's consider how an attack of the usual classic migraine passes, occurring mainly with a headache. There are several stages in its development:
- Prodromal period. There is a special condition that precedes the attack.
- Headache. This is the main stage of the attack, accompanied by excruciating pain.
- Recovery period. The pains gradually disappear, and the person's well-being is restored.
In some patients, visual disturbances occur before a headache. Otherwise they are called auras. In this case, doctors talk about ophthalmic migraine.
Visual aura can flow with different manifestations. In this regard, there are several forms of ocular migraine:
- retinal;
- ophthalmoplegic;
- basilar.
Next, we will take a closer look at the symptoms and treatment of ophthalmic migraine, depending on the form of the disease.
Symptomatics
Attack of eye migraine develops in several stages. Each period has its own special manifestations.
During an attack of ophthalmic migraine with auras, the following symptoms are noted:
- Prodromal period. A person feels very tired and drowsy, often yawns. There is a craving and need for sweet food. There is tension in the muscles of the back of the head. A person is irritated by bright lights and sounds. This period lasts from 1 hour to a day.
- Visual aura. Flickering bright flashes and spots appear before the eyes. Separate areas fall out of sight, up to the development of temporary blindness. A person perceives objects in a distorted form. Visual disturbances always occur in both eyes. At the same time, the person's hands go numb and speech becomes slurred. The visual aura lasts from 5 minutes to 1 hour.
- Headache. This period can last up to 24 hours. A person has excruciating pain in one half of the head. Reception of analgesics does not relieve discomfort. The pain is aggravated by bright light, sounds, pungent odors, often accompanied by nausea and vomiting. There is severe fatigue and drowsiness, but the headache keeps you awake.
- The final stage. The headache gradually subsides. The person feels exhausted and falls asleep quickly. Relief comes. The recovery period can last from several hours to several days.
Let's consider the features of the visual aura in different forms of ocular migraine.
A symptom of ophthalmic migraine in the retinal form is the appearance of a flickering spot (scotoma) in the field of view. Sometimes zigzag lines are visible in its center. It can be colored or colorless and come in a variety of shapes and sizes. Because of this, certain areas fall out of the field of view. The aura lasts about 15 - 20 minutes. In this case, there is a violation of the blood supply to the retina, which isreversible.
If the attack happened in the dark, then luminous dots and figures appear in the field of view. They are called phosphenes. Headache occurs mainly in the forehead and eye sockets. After the attack ends, vision and blood supply to the retina are fully restored.
Ophthalmoplegic form of ocular migraine is otherwise called Mobius' disease. During the aura, not only the appearance of spots in the field of vision is noted, but also the drooping of the upper eyelid, double vision, and strabismus. The pupils are greatly dilated, regardless of the illumination in the room. There is paralysis of the eye muscles. This form of the disease is more common in children.
The basilar form is noted mainly in adolescent girls. During the aura, there are flashes before the eyes and severe visual distortions. Large objects are perceived by patients as small. Short-term visual hallucinations are possible. It seems to patients that the surrounding objects change shape and color.
Pregnant women
As already mentioned, pregnant women are very prone to ocular migraine attacks. Atrial scotoma is usually noted in the first trimester. This is due to the fact that in the early stages of pregnancy there is a rapid restructuring of the body.
In most cases, after the third month of pregnancy, all symptoms of ophthalmic migraine disappear on their own. In rare cases, such manifestations persist at a later date. The complexity of the treatment lies in the fact that during this period women are contraindicatedmost medicines. If ocular migraine is mild and practically does not bother the patient, then treatment is not prescribed. In severe cases, the doctor selects the most gentle drugs.
Complications
How dangerous is ocular migraine? In advanced form, this disease can lead to unpleasant consequences:
- Seizures can become chronic and last for several weeks.
- The quality of peripheral vision may be significantly reduced.
- A prolonged attack of ophthalmic migraine can trigger blackouts or epilepsy.
- Eyes may become overly sensitive to bright light.
- The most dangerous complications of the disease are stroke and vascular aneurysm. Such consequences occur with severe circulatory disorders in the brain.
It can be concluded that this disease is far from harmless. If the attacks are repeated repeatedly, then you should seek medical help. Doctors diagnose this disease if a person has had at least five episodes of headache migraine.
Seizure help
How to help yourself during an ophthalmic migraine attack? The following measures will help alleviate the condition:
- If the light is on in the room, then it must be turned off. Sound stimuli also need to be eliminated.
- You need to lie down, relax and be quiet for a while. If possible, then you should try to sleep.
- It is useful to massage the head and collar area. However, this procedure should be trusted only by a specialist. Inept massage can aggravate the condition.
- You can rub the whiskey with mint oil or Star Balm.
- It is good to drink black tea with sugar.
During the first 2 hours of an attack, the following medications may help:
- "Validol" or "Nitroglycerin". You need to put one tablet under the tongue. This will help expand blood vessels and normalize blood circulation.
- "Amyl nitrite". 3-4 drops of the drug are applied to a cotton swab and sniffed for about 20 minutes. This remedy also gives a vasodilating effect.
- "Rizatriptan" or "Relpax". These are special medicines designed to relieve severe migraine attacks.
- "Ibuprofen" or "Paracetamol". Painkillers help with mild migraine attacks. With a strong pain syndrome, they are ineffective.
After the attack is over, it is useful to take a bath with preparations of pine needles or essential oils.
Diagnosis
To diagnose ophthalmic migraine, you need to contact a neurologist. It is also necessary to consult an ophthalmologist to exclude the presence of eye pathology.
Migraine must be differentiated from diseases of the retina. For this purpose, the following examinations are prescribed:
- external eye examination;
- ophthalmoscopy;
- determination of visual fields;
- visual acuity test;
- fundus examination;
- assessment of pupillary response to light exposure.
If the patient has no ophthalmic pathologies, then the neuropathologist prescribes an MRI or CT scan of the cerebral vessels. This helps to identify cerebral circulatory disorders.
Treatment methods
Treatment of ophthalmic migraine is aimed at preventing attacks. The therapy is preventive.
Prescribe drugs to improve cerebral circulation:
- "Cavinton".
- "Stugeron".
- "Nootropil".
- "Phenibut".
The nootropic Phenibut is especially indicated for stress-related migraines. It not only normalizes cerebral circulation, but also has a mild calming effect.
Recommended taking and other sedatives. With a mild form of the disease, herbal remedies based on valerian, motherwort, hawthorn are prescribed. In more severe cases, antidepressants and antipsychotics are prescribed.
Papazol and Eufillin are prescribed for vasodilatation. With eye fatigue, for prophylactic purposes, drops with vitamins are shown: "Taurine", "Riboflavin", "Taufon".
Currently widely used physiotherapy methods for the treatment of ophthalmic migraine:
- Bernard currents on the neck and eyes;
- influenced by sinusoidal currents;
- electrophoresis withnovocaine and papaverine;
- pine baths;
- mud applications on the collar area.
Doctors recommend patients to reconsider their lifestyle. It is important to prevent lack of sleep and overwork, avoid excessive exercise, quit smoking and alcohol.
Forecast
Prognosis of the disease is favorable. The disease is not dangerous for the life and work capacity of the patient. However, ocular migraine occurring with severe disorders of cerebral circulation can lead to serious vascular complications. Therefore, patients should be regularly observed by a neurologist and an ophthalmologist.
Prevention
To avoid ocular migraine attacks, patients should follow these guidelines:
- Avoid overwork and get good sleep.
- Keep active, get outdoors more often.
- Exclude from the diet of wine, cheeses, tomatoes, chocolate, milk. These products contain the amino acid tyramine, which is contraindicated in migraine.
- Do not abuse caffeinated drinks and foods.
- It is useful to keep a special diary, where to fix the attacks and the circumstances preceding their appearance. This will help identify precipitating factors and avoid them in the future.
- It is recommended to periodically undergo physiotherapy: massage sessions, aromatherapy, balneotherapy.
- Avoid excessive emotional and physical strain.
Patients suffering from ocular migraine should be under the supervision of doctors - a neurologist and an ophthalmologist. It is also necessary to regularly undergo an examination of the vessels of the brain. This will help to avoid disease progression and complications.
