Is this migraine or what is wrong with me?

Brain and nerves
1

Hello migraineurs,

I'm a 31 yo female and never really suffered from headaches before this year. I did have occasional (what I called) tension headaches, mild pains behind one eye that would last a few hours and that's about it. 

Last year in Novermber (8 months ago) I gave birth to my first child, by C-section. 2-3 days after the spinal anesthesia, I developped positional headaches that were incredibly intense. I was told they were related to the anesthesia. I couldn't sit or stand up, the pain was the worst thing imaginable, I would actually cry on the toilet when I needed to go. On a scale of 1 to 10 it was an 11. When I lied down it got better, a 2-3/10. The pains went away after 6-7 days and I got back to normal. However, during these 7 days I experience a scintillating scotoma almost identical to the auras that precede migraines. A dot of blurry shining lights that gradually grew larger and became a sparkling fortification spectrum in a C-shape which grew even larger until it left the vision field towards the left side. 

Then I had no problems whatsoever for the next 6 months or so and 1.5 months ago, I started having the aura again, it happened 6 times now. I've been very overworked and overtired when they started, with the baby starting solids and not sleeping well. A trying time... It's been so far 5 times on the left side of the vision and once on the right side. The transition of the scintillating scotoma from a dot to a large C leaving my field of vision lasts about 30 minutes and it's every time the same. No other symptoms, although I had mild nausea a couple of times during the aura.

The headaches that follow are mild. Like a stronger pressure in the back of the head, on the opposite side of the scotoma. So it has been mostly on the right side. A couple of hours after the aura I can always feel a sharper pain on the right, inside my head, towards the back of the head, usually when I move, bend over, cough, strain etc. It's every time on the same side in the same spot. This pain disappears every time after a day or so.

But for the last 2 weeks or so, I've been left with a slightly painful pressure in my head that's pretty constant. It sometimes goes away especially when I'm relaxed, but it comes back when I'm more tense. It feels a lot like a tension type headache. There is no particular pain when moving, coughing, bending over etc. like I have after the migraine. But I do feel more pressure in the back of my head on the right - not sure if it's psychological or it's really something there!

My brother started having the same aura (he described it to me in detail and it's the exact same thing I have) when he was 35, which was 5 years ago. His headaches are mild to moderate but they're behind his eye not at the back of the head like mine. He also doesn't have the head pressure every day like I started to...and his migraines alternate sides, not like mine which are predominantly on the right side of the head (left vision field).

I'm scheduled for an MRI next Wednesday, so I will find out more soon... but I wanted to hear your opinion... since I'm so very scared that I have a tumor in there, something really bad... and I very much want to see my baby grow up and be there for him. I'm super worried and I just had another aura this evening. Do my symptoms seem like migraines or maybe something worse?

I've read that I'm a bit too old to start having migraines (31) and that the pain should be more intense and not always on the same side and on the front of my head not at the back of my head. Is that true?

Thank you so much if you read all this! 

2

When I had my girls, I also had the same kind of migraines as yours, bad aura with no headache, very mild if anything.

You are having typical classical migraines, they will pass as your stress levels lessen. I still get them but only about 3 times a year.

Don't worry, they will pass.

Certainly not anything serious.

3

Hi Rebecca,

I'm a former neuro nurse - albeit from way back when - and I have to say I don't think there's the remotest chance you have a brain tumour.

The low-pressure headache you had after the spinal anaesthesia is normal, though yours seems to have been particularly bad.

Your age, the fact that you have a history of classic migraine in the family, the appearance of this phenomenon at times when you're tired and stressed, and the description of your attack all point to this being an acephalgic migraine (i.e. without a headache). Interesting too that you've now had the scotoma move to both sides. I would think that if this was due to a cerebral lesion it would be one-sided.

I'm glad you're getting an MRI though. It will give you the reassurance you need. I'm guessing you're not in the UK if it's happening that quickly! I'm not either, though I worked there as a nurse for 10 years when I was young.

So, here I am, being all reassuring, but as it happens I too was in a bit of a panic just four days ago. While sitting at my computer one afternoon, I suddenly noticed I had a binocular central scotoma. For the first 5-10 mins mine was completely opaque and grey - and growing. As I'm 73 and had never had anything like this in my life, and neither has anyone in my family, I immediately thought I was having some kind of stroke - at least a TIA! I even packed a small bag in preparation for going to the hospital, while all the while grinning at myself in the mirror to make sure I didn't have a facial weakness (which I didn't). As I live alone, I was concerned something might happen and I wouldn't be found for days.

As luck would have it, just at the moment I was reaching out towards the phone to call 112, the scotoma suddenly took on the form of black lines like the spokes of a wheel, and started rotating. Over the next couple of minutes it took a similar course to yours, moving to the right, then turning into a scintillating crescent of zig-zag lines and I finally recognised it as an aura - though not from any personal experience. For the last 15 minutes it took the form of a rather beautiful effect of fast-moving water under bright sunlight till, like yours, it dropped off the edge of my visual field. I had no headache, nausea or any other symptoms either during or after this episode - except for a wildly-pounding heart for the first 10 mins, till I figured out what was happening to me! It hasn't returned since.

I knew from my training that it was perfectly possible to get a migraine aura without the headache, but I was still slightly concerned about the fact that I'd had one for the first time at age 73. I didn't think that was normal. However, on researching, I discovered that though it usually starts before 40 (and you're in that age range) it's not rare for it to present for the first time late in life, and that when it does the attacks are more likely to be acephalgic, like mine. I'll still be checking it out with my GP the week after next. He's on holiday for one more week, and I don't want to see the locum.

As far as I know, there's no particular requirement for a migraine headache to be frontal though I understand most of them start there. Although I've never had classic migraine till now, I suffered badly from tension headaches when I was young and still working full-time, and these often started in the back of my head. I'm wondering whether you're sometimes getting the migraine aura at the same time as a tension headache - which wouldn't be surprising, as both can be caused by stress.

To sum up, I don't think you have anything at all to worry about. I hope I don't either!

Why don't you come back here and post again once you've had the results of the MRI? I'd like to know how you got on.

4

Thank you for putting my mind at ease! I think if it's not something more sinister, then stress is definitely a part and a trigger of these migraines & headaches. Did your aura also start after having your daughters?

5

Many many thanks for this very detailed response! I do hope you're right and there's definitely no tumor in there. The migraine headaches are pretty much always in the same spot and that's the thing that scares me the most to be honest. Always in the right occipital area, back of the head. The tension headaches that I have afterwards also give some occasional shooting pains in various areas of the head and many are on that occipital spot but I'm not convinced it's not muscular tension pinching some nerves. Who knows. I will get back with the MRI results when I have them. And yes, I'm not form the UK btw . How long does it take to have an MRI there?

I've just read that aura migraines that appear after the age of 65 are pretty much the same in etiology as those appearing after 45 and that the vast majority of them, over 90% or so are indeed migraines. So don't worry much about yours, it can still be a migraine at any age (easier said than done I know), but if it keeps happening again maybe it's a good idea to check with a doctor and an MRI. It is scary and it's scaring me pretty badly too, but like you said it's better to rule out stuff so you can relax .

It happened to you only once, right?

 

6

Hi Rebecca,

The fact that your headaches tend to occur in the same spot is more indicative of muscular involvement. Headaches due to brain tumours are far more likely to be generalised. Brain tissue itself has no pain sensors - brain surgery is sometimes carried out under local anaesthetic these days (to numb the scalp) so that the surgeon can check on the patient's reactions. The pain most often experienced as a result of brain tumours is generalised, rather than being felt in the area of the tumour, and is due to a general build-up of pressure inside the skull. It also tends to be constant and to increase steadily, for the same reason. It doesn't come and go.

I think it takes months to get an MRI in the UK, and I also think you'd be unlikely to qualify for one - which I'd actually agree with, as your symptoms don't indicate anything sinister. At best you'd probably get a less sensitive CT scan - and the massive dose of radiation that goes with it! I worked in their NHS as a nurse for 10 years in the 60s and 70s, and had to deal with it during the final illnesses of both my parents, but I had the great good fortune to escape to a country with a fully functioning health service 42 years ago.

Yes - I've only had the one aura. But as that was only five days ago I'm not surprised I haven't had another one yet. Still, if I do - and I think I probably will - at least I won't panic this time. I calmed down as soon as I started seeing the jagged lines, flashing lights, ripple effects etc. because I recognised them (from the literature and other people's accounts) as a migraine aura. It was the first 5 minutes or so, before all the SFX started, that freaked me out. During that time my central vision was completely blacked out by this static grey blob, that was getting bigger by the minute!

I've been reading the same NCBI articles as you, and am reassured. However, I see there is a small correlation between TIAs and late-onset aura so I might just run it past my GP anyway.

Get your MRI done, though I think the chances of it showing up anything are something like zero. And don't forget, an MRI will pick up on the tiniest brain lesion, unlike the far less sensitive CT scan. Once you've been reassured, stop thinking about brain tumours (or any other illnesses) and get on with enjoying your baby. Eight months is a lovely age, isn't it? Something new every day - but a lot of hard work too!

And come back and tell us about it once you get the result.

7

8 months is a really great age! I wish I had more energy and a better mood to enjoy it together with my baby and not have auras and a continuous headache every day. But I've been to 2 neurologists and they both denied me any treatment for my pain before having the MRI done. They said they won't prescribe anything more than ibuprofen (which doesn't help with that tension-pressure achy feeling in my head) unless they know for sure that I do not have something else. Like a brain tumor or an aneurysm. One of them actually said the words 'brain tumor' to me, throwing me into a panic. As if I am not stressed enough with being a (new) mother and working almost 24/7 while also having headaches and visual disturbances. Thank you doctor. So yes, I pretty much have to have the MRI or I will get no treatment for my condition.

I see you're very much in control of the way you react to your symptoms. I wish I was more like that, but I'm a bit of a scaredy cat. I used to have GAD and hypochondria for years up until I was finally diagnosed with hyperthyroidism which was the source for all the anxiety and every doctor I met was telling me it's 'all in my mind' and to just relax. I'm in fact a bit on the hyper side right now but taking treatment so maybe that's also a part of why I'm so afraid of all this migraine & MRI thing.

8

Well, I wasn't too much in control of my reactions when The Blob suddenly made its appearance, I can tell you! I spent 5-10 mins in total freak-out mode, convinced I was having a stroke and was going to permanently lose my sight.

Sorry to hear about the hyperthyroidism. I have the opposite - due to an autoimmune condition that's been nibbling at bits of my body for the past 22 years - but that's far easier to treat, of course. I'm convinced my mother was hyperthyroid. She was skinny as a rake, had the classic protruding eyes, was always hot and demanding all the doors and windows be left open (I used to get terrible chilblains every winter as a child), and suffered life-wrecking anxiety and anger-management problems. But the British health system isn't really into doing routine blood tests - and was even less so when she was young - so she never got diagnosed.

I'm glad you're having the MRI. I wasn't suggesting you shouldn't have it, just saying I'm fairly sure they won't find anything. Doctors have to sit on the fence when discussing these things with their patients. I think it's part of defensive medicine (avoidance of litigation) these days. In my days as a nurse it was completely the other way round. Patients were almost never told if there was anything seriously wrong with. I think that was wrong too.

Once again, good luck with the MRI. As far as I can make out, it's next Wednesday, not tomorrow.

9

Hi Lily,

I guess thyroid problems are super common, especially in women, so by those symptoms your mother definitely could have been hyper. My hyperthyroidism is also autoimmune (I actually have all the possible antibodies against my poor thyroid - both those that slow it down and those that speed it up, but the latter always get to tip the scale). When I'm seriously hyper I'm super anxious and agitated. I often feel like being on the verge of a panic attack and get angry super fast. I can't sleep and when I stand up my pulse is something around 140bpm. It's quite awful. I'm sure being hypo is no fun either. Any small imbalance in the body drags along so many other imbalances.

So-I had the MRI today. I still don't have the results which will be available tomorrow. So far I have no clue, I didn't get to talk to the radiologist and the nurse refused to give me any hints. Anyway, they didn't use the contrast (I was told it will be used only if the technician finds it necessary), so maybe they didn't find anything worth contrasting, like a tumor or whatever. I hope so! I think if they did find something abnormal they would've used it? 

I'll post the results tomorrow in any case.

10

Hi Rebecca,

I'm glad you've had the MRI. Obviously it has to be gone over carefully by a radiologist to check out the fine detail, but if there'd been a large tumour or aneurysm this would have been spotted straight away. In the case of a major aneurysm they probably wouldn't even have let you leave the hospital.

Has anyone ever suggested removing your thyroid? I know several women who've had a total thyroidectomy for Hashimoto's thyroiditis (which is perhaps what you have) and they all did really well afterwards. Sometimes it's better to get rid of the gland altogether and just take a replacement dose of L-thyroxine every day for the rest of your life. I was amazed at how little time they stayed in the hospital too. One was only in for one night, the others for two nights. In my nursing days people stayed in for about a week and quite a few of them got damage to the nerves supplying the larynx and ended up with husky voices too. I gather that never happens with modern-day techniques, and it's now considered a very minor op.

I look forward to hearing the results.

11

Hi Lily,

I was told by a couple of doctors (OBGYNs actually) that I should remove my thyroid so I get rid of all the problems related to it. But I'm not yet ready to part with my thyroid. First of all, it doesn't always go hyper. It has episodes of hyperactivity, but after I treat them for 2-3 months, it goes back to normal and stays normal for a long time, up to a year or so. More than that, if it stays just on the higher end of normal (which it often does), it helps speed up my metabolism a bit and I can eat whatever I want and not get fat and have a lot of energy. It's not always bad. But when it goes nuts, yes, that sucks and the symptoms are bad - but still I can take the treatment and it gets back to normal in 2-3 weeks. I'd rather not ditch it and then be dependent on some medication for the rest of my life. What if I don't tolerate it well after all or get side effects like some people do to synthetic thyroxine. So for now, unless it goes really berzerk for a long time, I'll be keeping my thyroid. Did you consider it? I think it makes more sense taking it out if it's always hypo, since you have to take the medication anyway.

In any case, I have received the MRI results today and they are good. There's just a pineal cyst and a left sided sinusitis. The Neurologist told me I'm fine and all my symptoms are migraine and tension headache from the stress. And that I'm probably a bit depressed and overtired by taking care of the baby. Which might be true. So good news, I do have (just) migraines .

12

Hi Rebecca,

I'm so glad to hear you don't have anything serious, and it's "only" migraines! Sinusitis can cause very bad headaches. I once had chronic sinusitis for several years, which in the end turned out to be down to a dental problem no one had spotted. I had terrible headaches during all that time. The pineal cyst is interesting, but unlikely to be large enough to cause your migraines or the neurologist would have commented on it. They're not all that rare. Lots of us have all kinds of anomalies - e.g. three or even four kidneys - without ever finding out about them.

Can't say I blame you for wanting to hold on to as much of yourself as you can! I'm the same. I had severe fibroids for some years in the run-up to the menopause but steadfastly refused a hysterectomy, in spite of the small risk they might turn malignant. I knew my mother, grandmother and one great-aunt had had the same thing, and it had cleared up suddenly at the menopause. In the event I was right. The whole thing stopped overnight. Quite literally - on 31 December 1989. I've never had a moment's trouble since.

No need for me to have a thyroidectomy as I never go hyper (well not so far, anyway) so just need regular blood tests to calibrate my dose of thyroxine. But I understand there's a risk my autoimmune condition could tip over into Hashimoto's as well - like so many of them - and I'd go straight for thyroidectomy if that ever happened. If ever it comes to it, there's no need to worry about reactions to L-thyroxine. They're very rare, as it's basically just a synthetic copy of what your body produces anyway. When I first went on it I had hot flushes, nausea and palpitations for a couple of weeks, but that was because I was adjusting to a normal level of thyroid hormones, having been left in a hypothyroid state for far too long before my doctor agreed to treat me.

I hope all continues to go well for you. You can always contact me via private message if you want to. Just click on the little envelope icon under my avatar. PMs via this site don't carry viruses or reveal the email address of either party.