Aura with no headache, two in last few months. Should I see my GP?

Brain and nerves
1

When I was in my twenties I used to get thumping, one-sided headaches which meant I had to lie down somewhere dark.   Looking back, I presume these were migraines, but I didn't go to the doctor about them.

Now I'm 71 and, for the past 15 years - maybe once a year -I have been having aura without any headache.  Again, I presume these are migraines.  I had one last year, then one in June this year and now another one yesterday.  I initially feel nauseous and slightly unwell, then I have blank spots in my vision which gradually fills with sparkling lights, often whirling in a circle.  I find it difficult to hold a conversation and feel very shaky.  After 30 minutes the lights fade and I'm left with a slight headache and 'thick' head.

I mentioned it to my GP three years ago when I saw him for something else and he checked me for stroke.  Everything was fine, so I put it to the back of my mind.  However, with now having had one in June and then another yesterday I realise that this is the first time I've had two episodes so close together before.

Do you think it's worth seeing my GP to discuss this?  I don't know that he could do anything, but wonder if it's worth mentioning that the frequency has increased a little.  What do you think?  Or am I worrying for nothing?  Does anyone else get these types of aura without headache?

   

2

Hi Cheetah,

My story is somewhat similar to yours. From the age of about 20 right through to when I retired from paid employment at age 66, I used to get regular severe headaches. Mine were of a "thumping" nature like yours, accompanied by nausea and vomiting, and could be really disabling. However, they affected both sides of my head (and often my ears) and could only be alleviated by propping myself in a sitting position in bed. They got much worse on lying flat. Also, it was sound that exacerbated them, rather than light. I never got a single aura in all that time.

They more or less stopped as soon as I retired - message in there somewhere! Although I've done a demanding voluntary job in the seven years since retirement, I never get severe headaches these days. I just get an occasional twinge that's easily fixed by taking a single 200mg tablet of Nurofen (ibuprofen).

Then, three months ago, at age 73, I suddenly got the first migraine aura I'd ever had in my life. It scared the life out of me for the first few minutes, as all I initially got was the rapidly-enlarging blank spot you describe. I too was convinced I was having a stroke, kept grinning at myself in the mirror to see if I had a facial weakness (I didn't) and was on the verge of calling an ambulance before the central blind spot started flashing and winking. It eventually started moving slowly out to the right, at which point the classic zig-zag black lines appeared, and I realised what it was. Apart from being a bit shaky (due to the scare I'd had) I had no other symptoms, either during or after the aura.

I immediately looked it up on-line and discovered that it's not uncommon for migraine auras to start late in life. The sites I consulted also said that in cases where the aura starts from about 60 onwards, the migraines are usually acephalgic - i.e. no headache. The general consensus was that they were not significant, and not a precursor of stroke.

I too wondered whether I ought to go and see my GP, but finally decided to wait as I'd just seen him a few days before this and have to see him every six months for my autoimmune condition anyway. (You and I have already met over on the Sjogrens board.) So far I haven't had another attack, but at least I'll know what it is if it ever happens again, rather than immediately freaking out!

I don't know whether the change in frequency of yours is significant, but my reading of the literature (as a former neuro nur se) is that it probably isn't. However, if you're worried about it, why not see your GP anyway? I'm due to see mine again early in the new year, so will probably hold on till then.

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Thanks Lily.  You've reassured me and I'm due to see the nurse practitioner at the practice for my annual checkup in a couple of months - I have high blood pressure.   I think I'll leave it till then and see what she says.  I can remember when I first experienced this when I was in my mid-fifties -  and, you're right, it's extremely scary.  Mine have sometimes come on when I've been reading and suddenly half the text disappears!  Yesterday, I was shopping and I was trying to hold a conversation with the shop assistant while being unable to see her face properly!

Still waiting to see if my referral re the dry eyes has been accepted, so we'll see how that goes.  Not really sure if it's Sjorgen's, but, as I've got another autoimmune disease, it's a possibility I suppose.   Anyway, it will be good to get it checked.   It's all go, isn't it?

Thanks again.  Take care.     

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Dear cheetah

I am 53 years old (two years into menopause!) never before had I had migraine auras but two years ago I was getting four a month! That stopped but only started up again in June and had six in a month and one month it was three. I know bright lights sets mine off (even looking at a passing car headlight did!) and looking at my phone in a darkened room can. I sometimes wonder if caffeine sets it off as they seem to happen in the mornings more. Sometimes I have woken up with an aura, so I'm not sure what sets that off (apart from my dry eyes perhaps?) I'm considering going back to the doctors as they have started up again, I have read that they can occur in menopause. My father said that he has these migraine auras (he's 81) so perhaps it is inherited?

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Thanks for your reply, Pinkcatfairy.  As far as inheritance goes, my younger son suffers from migraine with aura, so I've obviously, very kindly, passed it on to him!  I stopped drinking caffeine many years ago and feel all the better for it, so it might be worth a try giving it up to see if that makes a difference.  My auras seem to be triggered by tiredness, e.g. if I've not slept very well the night before.    I hope the GP is able to help and you're soon feeling a lot better.    

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Thanks for your reply! Yes I wonder if tiredness is a trigger too for me! I do try to have decaffeinated coffee at times but I must try to have it all the time.