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Migraine Auras

Program: Effective Treatments for Headache and Migraine
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Andrew Schorr:

Thanks for joining us today on Andrew Schorr's Patient Power. I'm the guy, Andrew Schorr, dedicated to helping you feel better. And if you have a headache, when it happens you don't feel good at all, so we're fortunate that we have Dr. Sylvia Lucas, director of the headache center at the University of Washington Medical Center here in the studio to take your calls. We've got three waiting and I've got a couple of open lines. We're going to buzz through them as quick as we can I was trying to get a call from Tacoma. Chloe called from Federal Way. Chloe, we're going to have you on in a second, working south. Okay, Sylvia? All right.

So Nancy from Mill Creek, you've been waiting so long patiently. And if you have a headache now, I hope not, it would be painful. Nancy, how are you doing and what's your question? Welcome to Patient Power.

Caller:

Doing great. Actually, I wish I did get the headaches. I get the migraine auras without headaches, and I'm wondering is there a way to prevent that.

Andrew Schorr:

Do you have spots before your eyes or what happens?

Caller:

It's just an event like a light show type event that lasts about 20 minutes.

Andrew Schorr:

Some people would like that.

Caller:

I know.

Andrew Schorr:

Some college kid or something would like that. So okay. So this happens at any particular time?

Caller:

Yeah. It can just happen randomly. Generally not that many times per year, but it's very annoying when it does.

Andrew Schorr:

Now, Sylvia, as a neurologist some people would say that's not so bad because they get the aura with the terrible pain, but certainly it's disruptive to Nancy's life. Is that associated?

Dr. Lucas:

Oh, absolutely. And I really feel for Nancy, because, Nancy, I had to give up playing college volleyball because every time I'd look back at the lights to spike the ball I'd immediately lose my vision with the same type of thing that you're talking about. For most people, it's called scintillating scotoma, so you see these jagged maybe black and white spots.

Caller:

That's the one.

Dr. Lucas:

Yeah, and they start in the middle of your vision and they kind of work their way out over about 20, 30 minutes?

Caller:

Yep.

Dr. Lucas:

Yeah. Those can be associated either before a migraine, you know, when the pain comes, or with it or after it or even, as you have, with no headache at all. And, yeah, Andy's right. Some people would kill to get a migraine like that where it doesn't hurt, but you can't drive, you can't read, you have to look all the way around a piece of paper to see what you're focusing using on. So for 20 minutes you just kind of have to sit down.

But those actually are treatable. They're not treatable with the same drugs that we treat migraines with because the triptans, the drugs that probably some physicians have tried to give you, I mean, they're very powerful for migraine pain but not aura. Aura is something that's happening inside of your brain. We know the brain is hyperexcitable, and as you get that aura something in your brain, what we call a wave depolarization, is moving forward from your visual cortex at about the same rate of speed that you're seeing that going across your eye, and then it goes away. But you can treat that. Some of us treat that with a combination of calcium channel blockers, like verapamil or amlodipine and a baby aspirin, and that might help.

Caller:

Oh, okay.

Andrew Schorr:

Would that be a way to start? With a baby aspirin?

Dr. Lucas:

Yeah. I would certainly take the baby aspirin, but you might have to ask your doctor for a prescription of a calcium channel blocker as well.

Andrew Schorr:

Nancy, so this is a perfect example, and this is what Patient Power is about. Your situation is unusual. Ron's was a minute ago too. This is where you have to be smart, and thank you so much for calling. Your doctor may be familiar with this or not. Sometimes you need to go to a specialist like Dr. Lucas, but ask questions, and that's what you're doing. So I wish you well with that and thank you for calling.

By the way, Sylvia calls me Andy because she's known me for a while. So it's okay. Normally it's Andrew. Okay. Thanks for calling in, Nancy. I hope that helped.

Caller:

Thanks.

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