On Migraine Scintillating Scotomas

I still remember when that happened to me, it was quite a bizarre experience. It started after coming back from a meeting where the room was all painted white and had some of the brightest light I had seen and then it started while I was coming back home in the car, it was a sunny winter day with bright white reflected snow.

I didn't feel the pain of a migraine like I usually do but the zigzag pattern started as a very small point in the middle of my vision, got home, lay down on the couch and the circle grew and grew. I'd say around two third of the outline of that circle was a zigzag and I vividly remember that there was a checkboard pattern around the part that wasn't zigzag.

It was hard to see at some point as it became bigger and bigger and I was beginning to panic. But there was an inner circle inside of it of clear vision and once the zigzag circle became so big that it was outside of my vision, I was back to normal vision.

I did some research back then to figure out what happened and saw all those medieval paintings and drawings that people with similar experience did. I would enjoy the experience much more today with that knowledge but it never happened again.

The experience last between 30-60 min.

I've been getting migraine auras with scintillating scotomas since I was 16 though it only happens about once every few months and they last a few minutes to a couple of hours so they have not been too debilitating. This article provides a great description.

First time I had one, I thought it was a stroke because I couldn't read anymore and I had paresthesia (numbness and tingling) in my hands and face. I believe the paresthesia is mostly brought on by anxiety/hyperventilation as I don't always get it.

My scintillating scotomas don't look very bright though. In fact, the first few times I had them, I didn't notice any color at all. I just noticed that part of my field of vision was missing. It's weird. You could be staring directly at someone's face but you cannot see part of it and yet you can see everything else normally. At the same time, there is no noticeable gap or hole or discontinuity in your field of vision. Just like the article mentions, it's like a distortion of space-time within the field of vision.

I don't think it's possible to accurately convey the experience through art but you can get a vague idea by looking at altered photos of human faces with 4 eyes and 2 mouths. You can feel your brain trying to create blind spots in order to make sense of what it's seeing. It's a bit like that except your brain isn't trying to hide specific features but a fixed portion of your field of view.

I get these regularly, but luckily they don’t go on to be actual migraines.

Drs have referred to this as “pre-migraine”. I’m glad that they don’t go on to full migraines as other members in my family have experienced debilitating episodes over the years.

I have tried to explain what I see to others but never had much luck.

The best example I could come up with was this: imagine sitting in a cinema where the screen is what you see out of your eyes (an obviously bad metaphor). Then imagine that someone behind the screen has stabbed thru with a knife and slashed a portion of the screen so that there is a flap that no longer holds any image.

That’s kinda what I see when I get one of these.

> As the scotoma’s shining edges recede across your field of vision, they trace a corresponding wave of electrical activity, a “spreading depression” crossing the cortex at 3 millimeters per minute.

I didn't realize the way scotomas grow mirrors the cortical spreading depression in your brain, but it makes sense! Explains why the scotoma doesn't really "vanish," it just gets bigger until expands past your field of vision.

I also wonder whether this proves that the scotomas I've had in dreams were real migraine auras and not just... dream artefacts or whatever.

The general shape is the same as in these pictures for me, and it expands in the typical way and direction, but for me it's like shards of broken glass strobing various colours. When I first got migraines I didn't even realise I was seeing them. The first sign something was wrong was when I was watch the TV and suddenly it was hard to understand what the actors were saying. When I focussed, I realised that it was because I couldn't see their mouths!

Unfortunately, nearly two decades on, smaller weird visual artefacts are now just daily life and I seem to be very sensitive to glare (and I break into a cold sweat pretty often because that's how an aura looks when it starts). I only get a few migraines a year, but they seem to have rearranged the furniture in my brain a bit.

I understand migraines. I lose my vision almost completely, and see only white. Sometimes I can make out things on the edges. It starts with my vision going wonky. I have these spots that show up before the migraine has hit me full on. I then start throwing up, and can't see, the light and sound are incredibly painful. The closet is the best place for me, with a towel stuffed under the door.

I had them frequently until I was in 9th grade, and they stopped, then returned again in my very late 20s. They're not as frequent when I was young, but I get them still about 2-3 times a year now.

The emergency rooms gave me Benadryl, Morphine and Ibuprofen. It does nothing. If I can get an Ambien (Zolpidem) in me before I throw up, I will sleep it off.

I don't wish these on anyone.

To those who suffer headaches after the aura, not many people realize there is an interesting trick. When you notice the first signs of your aura, try to close your eyes and either go to a dark room or cover your closed eyes with your hand (to make it as dark as possible). In many cases, this will result in a less visible aura and less intense headache.

I read about it on some obscure forum that I'm unable to find right now. Many people commented that it works for them. I tried it, and it definitely lowered the intensity of my ensuing headache. I used to use the time during and right after aura to do the most important things I had to do for the day before the headache took me out of commission for the next 6 hours. But now, on the first sign of aura, I try to close my eyes and go to a dark room. This makes my headaches much more bearable and shorter.

A few people claimed this allows them to stop the aura from spreading (it slowly fades for them as it moves and completely disappears before reaching the edge of their vision) and they don't have the headache at all. I wasn't able to do that, but it makes me wonder if the visual inputs coming from our eyes somehow intensify the wave that is spreading in our brains. And maybe closing our eyes and stopping the inputs from our eyes deprives it of some stimuli that it needs to progress?

Huh. I think this might be what I get maybe 3 or 4 times a year since my 20s.

This specular, colourless arch in the center of my view that slowly grows into a ring, grows larger and larger until it's just around my peripheral vision, and then is gone and that's that. No symptoms other than a kind of blindness where it is in my vision.

None of the artwork in this page really describe it well for me, though maybe they're trying to be more abstract. The example on Wikipedia is almost a perfect rendering of what I see, now that I've looked it up.

The blindness is a fascinating experience because the brain is clearly trying hard to fill in the blanks. I can look at text in a book and I see text in a book... but if I try to read any of the text it just kind of isn't there. I have to read by looking slightly away from the text.

It looks exactly like this:

https://www.youtube.com/watch?v=qVFIcF9lyk8

If anyone gets these and is in the dark as to a cause, I have found a very strong correlation with excessive caffeine intake. I have been wrestling a caffeine addiction under control, and have found that these always occur on the days when I relapse and have many cups of coffee or energy drinks. It isn't bidirectional-- lots of caffeine doesn't always cause the migraine-- but the migraines always happen only when I've had a lot of caffeine. Whereas when I'm on the wagon and consuming none, or normal amounts, I never have them anymore.

I'm not sure if it's the caffeine in and of itself or downstream of something like higher blood pressure, but the correlation is extremely strong.

As a migraineur, just about the last thing I want to look at is migraine art. That said, none of the pieces shown in the article are particularly good visual representations of the scintillating scotoma that I experience.

Here's how I usually describe what a migraine aura looks like:

It's just like the after-image you see after glancing directly at a bright light (like a light bulb's filament) then looking away or closing your eyes. Now imaging that after-image with a colorful scintillation along the edges, sometimes wrapping around a blind spot in your vision (not necessarily a black spot).

The cilia of a lobed comb jelly are close to what I'm talking about (video: https://youtu.be/LPu1juezWeg)

Auras are beautiful little harbingers of debilitation.

A few months ago, I was able to witness my aura from the very beginning. I was trying to fall asleep, and I suddenly realized there was a very faint tiny dot a bit below the center of my vision. It looked like a dead pixel on an LCD screen, but super tiny. It was very faint, almost black, at first. But it quickly became brighter. I focused on it, and I noticed that it wasn't a solid dot. Instead, it looked like it had the shape of a rectangle that was sort of morphing into another rectangle that was rotated by 45 degrees. A bit like a wireframe of a rectangle, actually. Then, the bright rectangle started pulsating and changing rapidly between very bright white and a dimmed white. That's when I realized that it must be an aura starting. It then followed the usual pattern of getting bigger and slowly moving out of my vision.

It was quite fascinating to observe it from the very beginning. But now I freak out every time I see any kind of white dot in my vision when I close my eyes at night. And actually, when you really focus, you will realize that there are many tiny white dots and weird shapes popping out when you close your eyes at night. We just never pay attention to that, but the "idle" activity in our brain and nerves generates some artifacts when we close our eyes.

As of about 5 years ago this started happening to me for some reason. I can confirm what another poster said - it comes as quite a shock the first time ! It happens to me about once a year now and it's painless but weird. I've never suffered from conventional (painful) migraines.

For me, it looks like this. Scroll down on this page to the Two Dimensions section and let that run a bit. When it starts swirling, imagine just taking a curved 1 cm wide slice of it, and overlaying it on your field of view.

Takes about 20 minutes to expand out of sight.

https://en.wikipedia.org/wiki/Cyclic_cellular_automaton

Mine was more like lightning. So no field behind it, a leading edge but only a leading edge and since it was outside the core field of focus it caused me to scan the field, which became tiresome.

It wasn't unlike how I felt on mushrooms, 20+ years before it happened. Only one, immediately saw a GP, got put on hypertension meds, never had another 30 years on.

Yeah this happens to me fairly often, you get the rainbow zigzags with a hole in reality in the center.

The really weird migraines are the ones where you get aphasia, now that’s scary.

https://youtu.be/IG7NuH5QTdE?si=L_h1SVbjMoowvo0A

Mine is a shimmering rainbow zigzag shape that starts as a point and expands into a halo with the center open to my normal vision until it goes out of my field of vision. Then the headache starts. A dark room and sleep helps me get through it.

Hasn't happened much, maybe 4 times in my life.

I d describe mine as some kind of a stroboscope. I don't t know if there s any pattern: I d say is more like parallel lines blinking. If I have that, I know the migraine is coming.

I get these, but there's no pain associated with them while they're happening. Hours later, there's a kind of "sore spot" in my brain that I can feel if I cough or sneeze, or shake my head quickly. The spot corresponds to where the spreading depression was -- so if the aura was on the left, I feel it on the right side of my brain and vice versa. Usually hurts for about a day before subsiding.

I've had dozens of these over years and learned to live with them. They seem to be triggered by stress and possibly caffeine, as others have noticed. Thankfully (?) they have become less painful over time.

Beautifully written little piece, on an interesting niche subject. Recommended!

For me its like ripples of water on brightly lit glass.

If you want to see one then just keep reading that black text on a white background of that page.