Worsening factors of persistent aura

Sarah A [subject #432], Intensity of persistent aura symptoms (upper image) worsens with acute attack of migraine with aura (lower image), 2007. "Normally my vision looks kind of like this photo (upper image). All over pixels that move and flicker. They flicker more rapidly and somehow more disturbingly when I'm having an attack (lower image). The worsening lasted through the day, then went back to normal VS the next day." © 2007 Sarah A (larger image see here and here) [more]

In addition to migraine attacks (MAS score items B.9 and B.10), virtually all known triggers of migraine (see Wöber et al., 2006) can act as worsening factors of the intensity of persistent aura symptoms, resulting in a transitory worsening (duration ≤ 7 days) of one or more of the sufferer's persisting perception disturbances. Visual stimuli, stress (psychological, physical and iatrogenic) and menses are the most reported worsening factors of persistent aura symptoms. Less common worsening factors include acoustic stimuli (especially loud noise), alcohol and caffeine, exercise, tiredness, fatigue, lack of sleep, physical stress from illness, anxiety, depression, focusing attention, sexual activity, circadian, seasonal, weather and other environmental factors.

Here's something useful about having your symptoms get worse for brief periods of time

"Here's something useful about having your symptoms get worse for brief periods of time: it usually means something is going on that I should stop. Like, I'm tired and need to sleep. Or I should quit drinking coffee for the day, or I'm getting sick and need to rest. A worsening of my visual symptoms has been an excellent predictor of either on actual migraine or a CFS-related collapse. It's a nice [unconditioned stimulus] + [conditioned stimulus] = icky consequence system. Now I can just see the visual signal [unconditioned stimulus] and try and abort the consequence."

(SopuliSusie [subject #405], Email to Klaus Podoll, September 8, 2007)

References

Wöber C, Holzhammer J, Zeitlhofer J, Wessely P, Wöber-Bingöl C. Trigger factors of migraine and tension-type headache: experience and knowledge of the patients. J Headache Pain 2006; 7: 188-195.