Migraine attacks

Transitory worsening of persistent aura symptoms with attacks of migraine without aura

The transitory worsening of a persistent aura symptom with an attack of migraine without aura has been included as item B.9 in the criteria of the MAS score.

SopuliSusie [subject #405], Glowing Blue Jay (persisting corona phenomenon), 2007. © 2007 SopuliSusie (larger image see here)

SopuliSusie [subject #405], Pre-migraine Blue Jay (worsening of persisting corona phenomenon heralding the headache of a migraine attack), 2007. © 2007 SopuliSusie (larger image see here) [here]

Ever since the onset of her 8th episode of persistent aura without infarction in March 2006, SopuliSusie (subject #405) perceives "fuzzy, glowy edges" around the contours of inanimate objects, animals or human beings. She made a set of 2 pictures illustrating the transitory worsening of this persisting corona phenomenon (Podoll and Robinson, 2001) with her recurrent attacks of migraine without aura.

"The one called Glowing Blue Jay is my normal every day vision. Edges are blurred and there's that glowing band around everything (although if it were to scale on that actual bird, that band would be larger, but in the overall perspective of my vision, this is about as obtrusive as it really seems). The one called Pre-migraine Blue Jay is what that looks like if it gets worse before an actual migraine headache. This is not a symptom that always worsens before a migraine, but when it does, it is obviously hard to ignore, and it is always the same color and pattern as the everyday version, but it is bigger and more obtrusive. It makes flowers look pretty though."

(SopuliSusie [subject #405], Email to Klaus Podoll, October 21, 2007)

SopuliSusie [subject #405], Transitory worsening (yellow, green and turquoise areas) of persistent bilateral paraesthesias (red and orange areas) heralding the headache of a migraine attack (frontal view with palmar representation of hands and dorsal of feet), 2008. © 2008 SopuliSusie (larger image see here)

Another symptom brought on by the same 8th episode of persistent aura in March 2006 (and significantly worsened by the 11th episode on October 2, 2007) are bilateral paraesthesias of the upper and lower extremities. As shown in the above illustration, SopuliSusie (subject #405) repeatedly experienced a transitory worsening of these persistent paraesthesias with her recurrent attacks of migraine without aura.

"In the picture the red and orange are my every day levels. It is red all the time, but during a normal day, I'll get the orange at different times. The other colors show the levels of worsening that can happen before I get a headache, or if I'm really upset about something, getting sick, or super, super tired. It eventually gets up to the sides of my face. It is always bilateral, and always worse on my finger and toes, and on my palms and the bottoms of my feet."

(SopuliSusie [subject #405], Email to Klaus Podoll, March 18, 2008)

Tobias [subject #418], Intensity of persistent aura featuring flickering (upper image) worsens with acute attack of migraine without aura (lower image), 2008. © 2008 Tobias [more]

Concomitant with an attack of migraine without aura on March 9, 2008, Tobias (subject #418) experienced a transitory worsening of the intensity of the persistent flickering in his entire visual field which had remained from his 5th episode of persistent aura without infarction. The next day, the intensity of persistent flickering was back to usual.

Transitory worsening of persistent aura symptoms with attacks of migraine with aura

The transitory worsening of a persistent aura symptom with an attack of migraine with aura represents item B.10 of the MAS score.

"Not sure what happened last night", commented ukshell (subject #532) on the phenomenon in question, reporting an attack of migraine with aura featuring a white scotoma with subsequent transitory worsening of the intensity of her persistent visual snow, TV like static and increased negative afterimages brought on by her 1st episode of persistent aura about half a year ago.

"Had a strange thing happen last night.

I got into bed, quite late and was very tired. And as I tried to sleep and close my eyes, the bottom corners of my eyes started closing in and going all white. It was pretty scary and I had to keep opening my eyes and blinking.

It was like everything was going to go all white and i might pass out but I didnt feel light headed or anything. I kept my eyes open for ages and the VS was worse. I had different coloured lights moving across my eyes when I had them open. I eventually fell asleep. Anyone else experienced this?

Not sure what triggered it. Earlier in the evening I felt muscle pain down my right arm and had pains behind my right ear.

Weird."

(ukshell [subject #532], Yuku forum Visual snow or static - General discussion - Not sure what happened last night..., March 9, 2008)

"Seeing white lasted about 10 minutes. Only when I closed my eyes did the colour creep in from the corners and feel like it was taking over. I felt very strange like I wasn't really there, like I was watching or feeling it for someone else.

My vs is still worst today and I woke with a bad head. Negative images are also particulary bad today. I am also very aware of my nose in my vision!

I shall try and make a picture."

(ukshell [subject #532], Yuku forum Visual snow or static - General discussion - Not sure what happened last night..., March 9, 2008)

jruddy [subject #515], Intensity of persistent aura featuring visual snow (upper image) worsens with acute attack of migraine aura without headache (lower image) featuring shimmering black and white gratings and depersonalization, 2008. © 2008 jruddy (larger images see here and here) [more]

"My visual symptoms weren't too bad as I was driving in to my appointment yesterday. The visual snow was present, as was mild tinnitus, but I can't think of anything else that was acting up or at least noticeable. It was an overcast day, but my sunvisor was down (out of habit, since VS against the sky is usually very distracting) I popped up my sun visor and the VS wasn't too bad, which was a welcome respite - normally it would be horrible against a grey sky.

But within a few minutes my VS went into overdrive and became more aura-like, with straight bright shimmering lines. I felt off, detached like I have in the past with bad visual snow. I definitely felt like I should not be driving, but I was almost at the neuro's office so I put the visor down and continued to drive.

The very bad aura-like VS only appeared in the part of my vision that was in the grey sky, not where the roads or buildings were. It remained against the sun-visor for around 10 minutes. I continued to feel off for around an hour. In general my VS was worse for the rest of the day."

(jruddy [subject #515], Yuku forum Visual snow or static - General discussion - Interesting episode, February 5, 2008)

"Yes, I had no headache. I will try to make an image [see above] for you."

(jruddy [subject #515], Yuku forum Visual snow or static - General discussion - Interesting episode, February 5, 2008; additions in square brackets by Klaus Podoll)

References

Podoll K, Robinson D. Corona phenomenon as visual aura symptom in migraine. Cephalalgia 2001; 21: 712-717.

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